Bronx Park Medical Surgical Associates PC

Primary specialty

Surgery PhysicianTaxonomy code 208600000X

Legal business name

BRONX PARK MEDICAL SURGICAL ASSOCIATES PC

Practice address

2016 Bronxdale Ave
Suite 202
Bronx, NY 10462-3388

Phone

(718) 863-8695

Fax

(718) 863-5147

NPI assigned

Jul 25, 2007

Organization subpart

No

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

Authorized official

Name

Stephen Dirusso, M.D.

Title

President

Phone

(718) 960-6126

Specialties & licenses 1

Addresses

Other identifiers 1

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

{
    "created_epoch": "1185321600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1185321600000",
    "number": "1043410269",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2016 BRONXDALE AVE",
            "address_2": "SUITE 202",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "104623388",
            "telephone_number": "718-863-8695",
            "fax_number": "718-863-5147"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2016 BRONXDALE AVE",
            "address_2": "SUITE 202",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "104623388",
            "telephone_number": "718-863-8695",
            "fax_number": "718-863-5147"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BRONX PARK MEDICAL SURGICAL ASSOCIATES PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-07-25",
        "last_updated": "2007-07-25",
        "status": "A",
        "authorized_official_last_name": "DIRUSSO",
        "authorized_official_first_name": "STEPHEN",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "718-960-6126",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Surgery",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE GROUP PROVIDER #",
            "identifier": "W38541",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Surgery Physician in Bronx, NY
• Providers in Bronx, 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 Jul 25, 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.