NPIMap

Organization Active NPI

Specialty Anesthesia, PLLC

  • Anesthesiology Physician
  • Staten Island, NY
National Provider Identifier
1003006743
Registry record updated Jan 5, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
Legal business name
SPECIALTY ANESTHESIA, PLLC
Practice address
1360 Hylan Blvd
Staten Island, NY 10305
Phone
(718) 667-3577
Fax
(718) 351-7151
NPI assigned
Jul 30, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 5, 2023

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Kenneth Chapman, M.D.NPI 1366494262
Title
Owner
Phone
(718) 667-3577

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207L00000X Primary

Addresses

Primary practice location

1360 Hylan Blvd
Staten Island, NY 10305

Mailing address

1360 Hylan Blvd
Staten Island, NY 10305-1922
Phone (718) 667-3577

Other practice location 1

1 Hollow Ln Ste 102
New Hyde Park, NY 11042-1219
Phone (516) 587-5500

Other practice location 2

860 5th Ave Ste 1B
New York, NY 10065-5856
Phone (212) 724-7246

Other practice location 3

1534 Victory Blvd
Staten Island, NY 10314-3548
Phone (718) 667-3577

Other practice location 4

1360 Hylan Blvd
Staten Island, NY 10305
Phone (718) 667-3577

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20080207000341 NY Part B Supplier - Clinic/Group Practice 7517040066 Receives reassigned benefits from 13 practitioners
Practice locations: Staten Island, NY; New York, NY; New Hyde Park, NY

National Provider Directory

National Provider Directory

Locations

1 Hollow Ln
Ste 102
New Hyde Park, NY 11042
Phone (516) 502-1897

373 Manor Rd
Staten Island, NY 10314

Practitioners & affiliated clinicians

Practitioners 16

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

View all 16

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1185753600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1672876800000",
    "number": "1003006743",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1360 HYLAN BLVD",
            "city": "STATEN ISLAND",
            "state": "NY",
            "postal_code": "103051922",
            "telephone_number": "718-667-3577"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1360 HYLAN BLVD",
            "city": "STATEN ISLAND",
            "state": "NY",
            "postal_code": "10305",
            "telephone_number": "718-667-3577",
            "fax_number": "718-351-7151"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1 Hollow Ln Ste 102",
            "address_purpose": "LOCATION",
            "city": "New Hyde Park",
            "state": "NY",
            "postal_code": "110421219",
            "country_code": "US",
            "telephone_number": "516-587-5500",
            "fax_number": "715-351-7151",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "860 5th Ave Ste 1B",
            "address_purpose": "LOCATION",
            "city": "New York",
            "state": "NY",
            "postal_code": "100655856",
            "country_code": "US",
            "telephone_number": "212-724-7246",
            "fax_number": "718-351-7151",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1534 Victory Blvd",
            "address_purpose": "LOCATION",
            "city": "Staten Island",
            "state": "NY",
            "postal_code": "103143548",
            "country_code": "US",
            "telephone_number": "718-667-3577",
            "fax_number": "718-351-7151",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1360 Hylan Blvd",
            "address_purpose": "LOCATION",
            "city": "Staten Island",
            "state": "NY",
            "postal_code": "10305",
            "country_code": "US",
            "telephone_number": "718-667-3577",
            "fax_number": "718-351-7151",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "SPECIALTY ANESTHESIA, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-07-30",
        "last_updated": "2023-01-05",
        "certification_date": "2023-01-05",
        "status": "A",
        "authorized_official_last_name": "CHAPMAN",
        "authorized_official_first_name": "KENNETH",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "718-667-3577",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Anesthesiology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Staten Island, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 5, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.