NPIMap

Organization Active NPI

Pediatric and Adolescent Medicine

  • Pediatric Adolescent Medicine Physician
  • New York, NY
National Provider Identifier
1073612768
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Adolescent Medicine PhysicianTaxonomy code 2080A0000X
Legal business name
PEDIATRIC AND ADOLESCENT MEDICINE
Practice address
390 W End Ave
New York, NY 10024-6107
Phone
(212) 787-1444
Fax
(212) 799-8620
NPI assigned
Sep 21, 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
Max Kahn
Title
Senior Partner in Practice
Phone
(212) 787-1444

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Adolescent Medicine Physician 2080A0000X NU Primary

Addresses

Primary practice location

390 W End Ave
New York, NY 10024-6107

Mailing address

390 W End Ave
New York, NY 10024-6107
Phone (212) 787-1444

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
33D0131875Pediatric and Adolescent Medicine LLP390 West End Avenue, Suite 1 E, New York, NY 10024ComplianceAug 30, 2027

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 15

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 15

NPI Registry JSON

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

{
    "created_epoch": "1158796800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1073612768",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "390 W END AVE",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100246107",
            "telephone_number": "212-787-1444",
            "fax_number": "212-799-8620"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "390 W END AVE",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100246107",
            "telephone_number": "212-787-1444",
            "fax_number": "212-799-8620"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PEDIATRIC AND ADOLESCENT MEDICINE",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-21",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "KAHN",
        "authorized_official_first_name": "MAX",
        "authorized_official_title_or_position": "SENIOR PARTNER IN PRACTICE",
        "authorized_official_telephone_number": "212-787-1444"
    },
    "taxonomies": [
        {
            "code": "2080A0000X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Adolescent Medicine",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, 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.
  • 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.