Organization Active NPI

Robert C. Ciardullo, MD

  • Plastic Surgery Physician
  • White Plains, NY
National Provider Identifier
1083989073
Registry record updated Mar 9, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Plastic Surgery PhysicianTaxonomy code 208200000X
Legal business name
ROBERT C. CIARDULLO, MD
Practice address
170 Maple Ave.
Suite 305
White Plains, NY 10601-4714
Phone
(914) 948-4636
Fax
(914) 328-8628
NPI assigned
Mar 9, 2012
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 9, 2012

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

Authorized official

Name
Robert C Ciardullo, M.D.NPI 1548250194
Title
President
Phone
(914) 948-4636

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
Plastic Surgery PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 208200000X Primary

Addresses

Primary practice location

170 Maple Ave.
Suite 305
White Plains, NY 10601-4714

Mailing address

170 Maple Ave.
Suite 305
White Plains, NY 10601-4714
Phone (914) 948-4636

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20120320000640 NY Part B Supplier - Clinic/Group Practice 5496915977 Receives reassigned benefits from 1 practitioner
Practice locations: White Plains, NY; N White Plains, NY

National Provider Directory

National Provider Directory

Locations

811 N Broadway
Ste 101
White Plains, NY 10603
Phone (914) 949-7722

170 Maple Ave
Ste 305
White Plains, NY 10601
Phone (914) 849-2690

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": "1331251200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1331251200000",
    "number": "1083989073",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "170 MAPLE AVE.",
            "address_2": "SUITE 305",
            "city": "WHITE PLAINS",
            "state": "NY",
            "postal_code": "106014714",
            "telephone_number": "914-948-4636",
            "fax_number": "914-328-8628"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "170 MAPLE AVE.",
            "address_2": "SUITE 305",
            "city": "WHITE PLAINS",
            "state": "NY",
            "postal_code": "106014714",
            "telephone_number": "914-948-4636",
            "fax_number": "914-328-8628"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ROBERT C. CIARDULLO, MD",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-03-09",
        "last_updated": "2012-03-09",
        "status": "A",
        "authorized_official_last_name": "CIARDULLO",
        "authorized_official_first_name": "ROBERT",
        "authorized_official_middle_name": "C",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "914-948-4636",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "208200000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Plastic Surgery",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in White Plains, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 9, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.