Organization Active NPI

Well-Being Pediatrics & Adolescent Medicine, PLLC

  • Pediatrics Physician
  • Ithaca, NY
National Provider Identifier
1053994889
Registry record updated Sep 3, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
Legal business name
WELL-BEING PEDIATRICS & ADOLESCENT MEDICINE, PLLC
Practice address
402 3Rd St
Ithaca, NY 14850-3484
Phone
(607) 602-2083
Fax
(607) 208-7244
NPI assigned
Apr 29, 2021
Last updated
Sep 3, 2021By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 3, 2021

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

Authorized official

Name
Dr. Jessica Casey, DO
Title
Owner
Phone
(607) 602-2083

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 208000000X Primary

Addresses

Primary practice location

402 3Rd St
Ithaca, NY 14850-3484

Mailing address

402 3Rd St
Ithaca, NY 14850-3484
Phone (607) 602-2083

Other identifiers 1

IdentifierTypeStateIssuer
02272517MedicaidNY

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
33D2225790Jessica Casey Well-Being Pediatrics & Adolescent402 3Rd St, Ithaca, NY 14850Certificate of waiverMay 24, 2027

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1619654400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1630627200000",
    "number": "1053994889",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "402 3RD ST",
            "city": "ITHACA",
            "state": "NY",
            "postal_code": "148503484",
            "telephone_number": "607-602-2083",
            "fax_number": "607-208-7244"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "402 3RD ST",
            "city": "ITHACA",
            "state": "NY",
            "postal_code": "148503484",
            "telephone_number": "607-602-2083",
            "fax_number": "607-208-7244"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WELL-BEING PEDIATRICS & ADOLESCENT MEDICINE, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-04-29",
        "last_updated": "2021-09-03",
        "certification_date": "2021-09-03",
        "status": "A",
        "authorized_official_last_name": "CASEY",
        "authorized_official_first_name": "JESSICA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "607-602-2083",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DO"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Pediatrics",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02272517",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Ithaca, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 3, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.