Organization Active NPI

Madonna Physicians Services PC

Doing business as Madonna Perinatal Services

  • Maternal & Fetal Medicine Physician
  • Mineola, NY
National Provider Identifier
1073606992
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Maternal & Fetal Medicine PhysicianTaxonomy code 207VM0101X
License
217664 Issued in NY
Legal business name
MADONNA PHYSICIANS SERVICES PC
Doing business as
Madonna Perinatal Services
Practice address
300 Old Country Rd
Mineola, NY 11501
Phone
(516) 747-4616
Fax
(516) 747-4756
NPI assigned
Oct 2, 2006
Last updated
Aug 22, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Terry Spector
Title
Administrator
Phone
(516) 633-5018

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Maternal & Fetal Medicine Physician 207VM0101X 135376 NY
Maternal & Fetal Medicine Physician 207VM0101X 217664 NY Primary

Addresses

Primary practice location

300 Old Country Rd
Mineola, NY 11501

Mailing address

375 N Boradway
Suite LL2
Jericho, NY 11753
Phone (516) 433-5018

Other names 1

  • Madonna Perinatal Services Doing business as

National Provider Directory

National Provider Directory

Locations

400 W Main St
Ste 160
Babylon, NY 11702

375 N Broadway
Ste LL2
Jericho, NY 11753
Phone (516) 433-5018

8002 Kew Gardens Rd
#L1
Kew Gardens, NY 11415
Phone (718) 544-5151

131 Sunnyside Blvd
Plainview, NY 11803
Phone (516) 418-8058

Practitioners & affiliated clinicians

Practitioners 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1159747200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1073606992",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "375 N BORADWAY",
            "address_2": "SUITE LL2",
            "city": "JERICHO",
            "state": "NY",
            "postal_code": "11753",
            "telephone_number": "516-433-5018",
            "fax_number": "516-433-5084"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "300 OLD COUNTRY RD",
            "city": "MINEOLA",
            "state": "NY",
            "postal_code": "11501",
            "telephone_number": "516-747-4616",
            "fax_number": "516-747-4756"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MADONNA PHYSICIANS SERVICES PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-02",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "SPECTOR",
        "authorized_official_first_name": "TERRY",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "516-633-5018"
    },
    "taxonomies": [
        {
            "code": "207VM0101X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology, Maternal & Fetal Medicine",
            "state": "NY",
            "license": "135376",
            "primary": false
        },
        {
            "code": "207VM0101X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology, Maternal & Fetal Medicine",
            "state": "NY",
            "license": "217664",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Madonna Perinatal Services",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Mineola, NY

Sources for this page

  • 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.