Rockland Surgical Associates, P.C.

Primary specialty

Surgery PhysicianTaxonomy code 208600000X

License

149544 Issued in NY

Legal business name

ROCKLAND SURGICAL ASSOCIATES, P.C.

Practice address

275 N Middletown Rd Ste 1F
Pearl River, NY 10965-1189

Phone

(845) 735-6699

Fax

(845) 735-7999

NPI assigned

Dec 11, 2006

Organization subpart

No

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

Authorized official

Name

Wagdi F Ibrahim, M.D.

Title

President

Phone

(845) 735-6699

Specialties & licenses 1

Addresses

Other identifiers 4

Locations

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

{
    "created_epoch": "1165795200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1043370943",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "275 N MIDDLETOWN RD STE 1F",
            "city": "PEARL RIVER",
            "state": "NY",
            "postal_code": "109651189",
            "telephone_number": "845-735-6699",
            "fax_number": "845-735-7999"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "275 N MIDDLETOWN RD STE 1F",
            "city": "PEARL RIVER",
            "state": "NY",
            "postal_code": "109651189",
            "telephone_number": "845-735-6699",
            "fax_number": "845-735-7999"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ROCKLAND SURGICAL ASSOCIATES, P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-11",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "IBRAHIM",
        "authorized_official_first_name": "WAGDI",
        "authorized_official_middle_name": "F",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "845-735-6699",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Surgery",
            "state": "NY",
            "license": "149544",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "4096768",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OXFORD INSURANCE",
            "identifier": "RS099",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "US HEALTHCARE INSURANCE",
            "identifier": "0096189",
            "state": "NY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00838862",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Surgery Physician in Pearl River, NY
• Providers in Pearl River, NY by specialty
• Surgery Physician in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.