Active NPI
Physician Affiliate Group of New York PC
- Registered Dietitian
- New York, NY
National Provider Identifier
1013375526
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Dietitian
- License
- 001002
- Legal business name
- PHYSICIAN AFFILIATE GROUP OF NEW YORK PC
- Practice address
- 506 Lenox Ave
New York, NY 10037-1802 - Phone
- (212) 939-2467
- NPI assigned
- Jan 29, 2016
- Last updated
- Sep 15, 2020
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Mr. Michael H. Lewensohn
- Title
- Medical Credentialing
- Phone
- (914) 403-8985
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Registered Dietitian | 133V00000X | 001002 | NY | Primary |
Addresses
Primary practice location
506 Lenox Ave
New York, NY 10037-1802
Mailing address
506 Lenox Ave
New York, NY 10037-1802
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in NY
Enrollment records 1
National Provider Directory
National Provider DirectoryLocations
1649 Surf Ave
Brooklyn, NY 11224
Phone (718) 616-6040
506 Malcolm X Blvd
New York, NY 10037
Phone (212) 939-1000
55 W 125th St
Rm 1001
New York, NY 10027
Practitioners & affiliated clinicians
Practitioners 2,396
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.
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NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1454025600000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1600128000000",
"number": "1013375526",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "506 LENOX AVE",
"city": "NEW YORK",
"state": "NY",
"postal_code": "100371802"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "506 LENOX AVE",
"city": "NEW YORK",
"state": "NY",
"postal_code": "100371802",
"telephone_number": "212-939-2467"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "PHYSICIAN AFFILIATE GROUP OF NEW YORK PC",
"organizational_subpart": "NO",
"enumeration_date": "2016-01-29",
"last_updated": "2020-09-15",
"certification_date": "2020-09-15",
"status": "A",
"authorized_official_last_name": "LEWENSOHN",
"authorized_official_first_name": "MICHAEL",
"authorized_official_middle_name": "H.",
"authorized_official_title_or_position": "MEDICAL CREDENTIALING",
"authorized_official_telephone_number": "914-403-8985",
"authorized_official_name_prefix": "Mr."
},
"taxonomies": [
{
"code": "133V00000X",
"taxonomy_group": "",
"desc": "Dietitian, Registered",
"state": "NY",
"license": "001002",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
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Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 15, 2020; 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.