Active NPI
Noah Burroughs
- Home Modifications Contractor
- North Baldwin, NY
National Provider Identifier
1104245299
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Home Modifications Contractor
- License
- 337436234
- Practice address
- 1842 Westervelt Ave
North Baldwin, NY 11510-2228 - Phone
- (646) 359-7911
- NPI assigned
- Apr 16, 2014
- Sex
- Male
- 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 |
|---|---|---|---|---|
| Home Modifications Contractor | 171WH0202X | 337436234 | NY | Primary |
Addresses
Primary practice location
1842 Westervelt Ave
North Baldwin, NY 11510-2228
Mailing address
1842 Westervelt Ave
Baldwin, NY 11510
Phone (646) 359-7911
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 12334354 | 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)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 337436234 | NY | MD | Home Modifications Contractor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1397606400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1397606400000",
"number": "1104245299",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1842 WESTERVELT AVE",
"city": "BALDWIN",
"state": "NY",
"postal_code": "11510",
"telephone_number": "646-359-7911"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1842 WESTERVELT AVE",
"city": "NORTH BALDWIN",
"state": "NY",
"postal_code": "115102228",
"telephone_number": "646-359-7911"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BURROUGHS",
"first_name": "NOAH",
"name_prefix": "Mr.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2014-04-16",
"last_updated": "2014-04-16",
"status": "A"
},
"taxonomies": [
{
"code": "171WH0202X",
"taxonomy_group": "",
"desc": "Contractor, Home Modifications",
"state": "NY",
"license": "337436234",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "12334354",
"state": "NY"
}
],
"endpoints": [],
"other_names": []
}Other providers in North Baldwin, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 16, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.