Organization Active NPI

Preferred Pediatrics of Rockland, LLC

  • Specialist
  • Suffern, NY
National Provider Identifier
1063568053
Registry record updated Apr 20, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
100063 Issued in NY
Legal business name
PREFERRED PEDIATRICS OF ROCKLAND, LLC
Practice address
100 Route 59
Suite 104
Suffern, NY 10901-4927
Phone
(845) 357-5020
Fax
(845) 357-5033
NPI assigned
Jan 25, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 20, 2008

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

Authorized official

Name
Richard Sirop, M.D.NPI 1023185840
Title
Delegated Official
Phone
(845) 357-5020

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 1

Specialty (taxonomy)CodeLicenseStatePrimary
SpecialistGroup: 193400000X SINGLE SPECIALTY GROUP 174400000X 100063 NY Primary

Addresses

Primary practice location

100 Route 59
Suite 104
Suffern, NY 10901-4927

Mailing address

100 Route 59
Suite 104
Suffern, NY 10901-4927
Phone (845) 357-5020

Other identifiers 2

IdentifierTypeStateIssuer
0048210OtherNYAETNA HMO GROUP#
7868161OtherNYAETNA PPO GROUP #

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
33D0141173Preferred Pediatrics of Rockland, LLC100 Route 59, Suffern, NY 10901Certificate of waiverJun 27, 2027

National Provider Directory

National Provider Directory

Locations

100 Route 59
Ste 104
Suffern, NY 10901
Phone (845) 357-5020

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1169683200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1208649600000",
    "number": "1063568053",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 ROUTE 59",
            "address_2": "SUITE 104",
            "city": "SUFFERN",
            "state": "NY",
            "postal_code": "109014927",
            "telephone_number": "845-357-5020",
            "fax_number": "845-357-5033"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 ROUTE 59",
            "address_2": "SUITE 104",
            "city": "SUFFERN",
            "state": "NY",
            "postal_code": "109014927",
            "telephone_number": "845-357-5020",
            "fax_number": "845-357-5033"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PREFERRED PEDIATRICS OF ROCKLAND, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-25",
        "last_updated": "2008-04-20",
        "status": "A",
        "authorized_official_last_name": "SIROP",
        "authorized_official_first_name": "RICHARD",
        "authorized_official_title_or_position": "DELEGATED OFFICIAL",
        "authorized_official_telephone_number": "845-357-5020",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Specialist",
            "state": "NY",
            "license": "100063",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA HMO GROUP#",
            "identifier": "0048210",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA PPO GROUP #",
            "identifier": "7868161",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Suffern, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 20, 2008; 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.