Individual provider Active NPI

Steven Keith Palumbo, M.D.

  • Plastic Surgery Physician
  • Quogue, NY
National Provider Identifier
1043313307
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Plastic Surgery PhysicianTaxonomy code 208200000X
License
135296 Issued in NY
Practice address
25 Montauk Highway
Quogue, NY 11959-1609
Phone
(631) 653-6112
Fax
(631) 653-5899
NPI assigned
Sep 5, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Plastic Surgery Physician 208200000X 135296 NY Primary

Addresses

Primary practice location

25 Montauk Highway
Quogue, NY 11959-1609

Mailing address

25 Montauk Highway
P.O. Box 1609
Quogue, NY 11959-1609
Phone (631) 653-6112

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
135296NYMDPlastic Surgery Physician

NPI Registry JSON

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

{
    "created_epoch": "1157414400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1043313307",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "25 MONTAUK HIGHWAY",
            "address_2": "P.O. BOX 1609",
            "city": "QUOGUE",
            "state": "NY",
            "postal_code": "119591609",
            "telephone_number": "631-653-6112",
            "fax_number": "631-653-5899"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "25 MONTAUK HIGHWAY",
            "city": "QUOGUE",
            "state": "NY",
            "postal_code": "119591609",
            "telephone_number": "631-653-6112",
            "fax_number": "631-653-5899"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PALUMBO",
        "first_name": "STEVEN",
        "middle_name": "KEITH",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-09-05",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208200000X",
            "taxonomy_group": "",
            "desc": "Plastic Surgery",
            "state": "NY",
            "license": "135296",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Quogue, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.