Active NPI
Selma Sheridan
- Ophthalmology Physician
- Oswego, NY
National Provider Identifier
1093751901
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Ophthalmology Physician
- License
- 132758
- Practice address
- 209 W 7TH St
Oswego, NY 13126-3676 - Phone
- (315) 343-9022
- Fax
- (315) 342-4906
- NPI assigned
- Jun 20, 2006
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Ophthalmology Physician | 207W00000X | 132758 | NY | Primary |
Addresses
Primary practice location
209 W 7TH St
Oswego, NY 13126-3676
Mailing address
209 W 7TH St
Oswego, NY 13126-3676
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 00554476 | Medicaid | NY |
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)
- Enrolled
- Credentials
- Doctor of Medicine
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Port City Family Medicine P.C. Inc | Past | Accepting new patients |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- Family Medicine Physician
- Oswego, NY
- NPI 1215028055
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1150761600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1093751901",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "209 W 7TH ST",
"city": "OSWEGO",
"state": "NY",
"postal_code": "131263676"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "209 W 7TH ST",
"city": "OSWEGO",
"state": "NY",
"postal_code": "131263676",
"telephone_number": "315-343-9022",
"fax_number": "315-342-4906"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SHERIDAN",
"first_name": "SELMA",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2006-06-20",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "207W00000X",
"taxonomy_group": "",
"desc": "Ophthalmology",
"state": "NY",
"license": "132758",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "00554476",
"state": "NY"
}
],
"endpoints": [],
"other_names": []
}Other providers in Oswego, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.