Crystal Run Medical Services PC

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

Legal business name

CRYSTAL RUN MEDICAL SERVICES PC

Practice address

236 Crystal Run Rd
Suite 2
Middletown, NY 10941-4009

Phone

(845) 692-3100

Fax

(845) 692-2402

NPI assigned

Sep 14, 2006

Last updated

Aug 22, 2020By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Raymond S Basri, MDNPI 1659350163

Title

Owner

Phone

(845) 692-3100

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in NY

Enrollment records 1

Locations

Practitioners 6

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.

• Raymond S Basri, MD

  • Internal Medicine Physician
  • Middletown, NY
  • NPI 1659350163
  Medicare reassignment NPD Authorized official
• John Podeszwa, M.D

  • Gastroenterology Physician
  • Middletown, NY
  • NPI 1841291697
  Medicare reassignment NPD
• Maurice Alisse, PA-C

  • Physician Assistant
  • Newburgh, NY
  • NPI 1730130386
  Medicare reassignment
• Tara Rose Flanagan, MPA-C

  • Physician Assistant
  • Montgomery, NY
  • NPI 1275925125
  Medicare reassignment
• Marc J Rosenblatt, DO

  • Pain Medicine (Physical Medicine & Rehabilitation) Physician
  • Spring Valley, NY
  • NPI 1164422895

  Single Specialty

  NPD (past)
• Rebeca Wine, PA

  • Physician Assistant
  • New York, NY
  • NPI 1174388680
  NPD (past)

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

{
    "created_epoch": "1158192000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1104921139",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "236 CRYSTAL RUN RD",
            "address_2": "SUITE 2",
            "city": "MIDDLETOWN",
            "state": "NY",
            "postal_code": "109414009",
            "telephone_number": "845-692-3100",
            "fax_number": "845-692-2402"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "236 CRYSTAL RUN RD",
            "address_2": "SUITE 2",
            "city": "MIDDLETOWN",
            "state": "NY",
            "postal_code": "109414009",
            "telephone_number": "845-692-3100",
            "fax_number": "845-692-2402"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CRYSTAL RUN MEDICAL SERVICES PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-14",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "BASRI",
        "authorized_official_first_name": "RAYMOND",
        "authorized_official_middle_name": "S",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "845-692-3100",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Crystal Run Healthcare LLP
• Crystal Run Healthcare Physicians LLP
• Crystal Run Healthcare Physicians LLP
• Crystal Run Healthcare Physicians LLP
• Crystal Run Healthcare Physicians LLP
• Crystal Run Pharmacy LLC (Crystal Run Pharmacy)
• Crystal Run Pharmacy LLC
• Crystal Run Village
• Crystal Run Village Inc
• Crystal Run Village Inc

• Internal Medicine Physician in Middletown, NY
• Providers in Middletown, NY by specialty
• Internal Medicine Physician in New York

• 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 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.