Individual provider Active NPI

Daryle Scott Conlin

  • Hearing Instrument Specialist
  • Amsterdam, NY
National Provider Identifier
1083981328
Registry record updated Jul 20, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Hearing Instrument SpecialistTaxonomy code 237700000X
License
14000011872 Issued in NY
Practice address
2440 Riverfront Ctr
Amsterdam, NY 12010-4612
Phone
(518) 210-5440
Fax
(518) 843-3217
NPI assigned
Nov 30, 2011
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 20, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Hearing Aid Equipment 332S00000X 14000011872 NY
Hearing Instrument Specialist 237700000X 14000011872 NY Primary

Addresses

Primary practice location

2440 Riverfront Ctr
Amsterdam, NY 12010-4612

Mailing address

96 Minaville St
Amsterdam, NY 12010-5608
Phone (518) 210-5440

Other identifiers 1

IdentifierTypeStateIssuer
14000011872OtherNYNY STATE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
14000011872NYMDHearing Aid Equipment

NPI Registry JSON

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

{
    "created_epoch": "1322611200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658275200000",
    "number": "1083981328",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "96 MINAVILLE ST",
            "city": "AMSTERDAM",
            "state": "NY",
            "postal_code": "120105608",
            "telephone_number": "518-210-5440"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2440 RIVERFRONT CTR",
            "city": "AMSTERDAM",
            "state": "NY",
            "postal_code": "120104612",
            "telephone_number": "518-210-5440",
            "fax_number": "518-843-3217"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CONLIN",
        "first_name": "DARYLE",
        "middle_name": "SCOTT",
        "name_prefix": "Mr.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2011-11-30",
        "last_updated": "2022-07-20",
        "certification_date": "2022-07-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "332S00000X",
            "taxonomy_group": "",
            "desc": "Hearing Aid Equipment",
            "state": "NY",
            "license": "14000011872",
            "primary": false
        },
        {
            "code": "237700000X",
            "taxonomy_group": "",
            "desc": "Hearing Instrument Specialist",
            "state": "NY",
            "license": "14000011872",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NY STATE",
            "identifier": "14000011872",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Amsterdam, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 20, 2022; 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.