NPIMap

Organization Active NPI

Island Medical Empire State, PLLC

  • Emergency Medicine Physician
  • Oneonta, NY
National Provider Identifier
1053623041
Registry record updated May 25, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
Legal business name
ISLAND MEDICAL EMPIRE STATE, PLLC
Practice address
One Norton Avenue, Emergency Department
A. O. Fox Memorial Hospital
Oneonta, NY 13820-2629
Phone
(607) 431-5003
Fax
(607) 431-5058
NPI assigned
Jul 8, 2010
Last updated
May 25, 2016By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 25, 2016

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

Authorized official

Name
Dr. Daniel R. Ferrara, D.O.NPI 1811973852
Title
President
Phone
(631) 514-7600

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 5

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X
Nurse Practitioner 363L00000X
Emergency Medicine Physician 207P00000X Primary
Family Medicine Physician 207Q00000X
Internal Medicine Physician 207R00000X

Addresses

Primary practice location

One Norton Avenue, Emergency Department
A. O. Fox Memorial Hospital
Oneonta, NY 13820-2629

Mailing address

350 Motor Pkwy
Suite 309
Hauppauge, NY 11788-5101
Phone (631) 514-7600

Other names 1

  • Pegasus Medicine Group Empire State, PLLC Former legal business name

National Provider Directory

National Provider Directory

Locations

1 Norton Ave
Oneonta, NY 13820
Phone (607) 431-5003

1 Norton Ave
#A
Oneonta, NY 13820
Phone (607) 431-5003

Practitioners & affiliated clinicians

Practitioners 81

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.

View all 81

NPI Registry JSON

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

{
    "created_epoch": "1278547200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1464134400000",
    "number": "1053623041",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "350 MOTOR PKWY",
            "address_2": "SUITE 309",
            "city": "HAUPPAUGE",
            "state": "NY",
            "postal_code": "117885101",
            "telephone_number": "631-514-7600",
            "fax_number": "631-813-1472"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "ONE NORTON AVENUE, EMERGENCY DEPARTMENT",
            "address_2": "A. O. FOX MEMORIAL HOSPITAL",
            "city": "ONEONTA",
            "state": "NY",
            "postal_code": "138202629",
            "telephone_number": "607-431-5003",
            "fax_number": "607-431-5058"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ISLAND MEDICAL EMPIRE STATE, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-07-08",
        "last_updated": "2016-05-25",
        "status": "A",
        "authorized_official_last_name": "FERRARA",
        "authorized_official_first_name": "DANIEL",
        "authorized_official_middle_name": "R.",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "631-514-7600",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.O."
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Pegasus Medicine Group Empire State, PLLC",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

Other providers in Oneonta, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 25, 2016; 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.