Organization Active NPI

Parkmed, LLC

  • Ambulatory Surgical Clinic/Center
  • New York, NY
National Provider Identifier
1104992072
Registry record updated Feb 19, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ambulatory Surgical Clinic/CenterTaxonomy code 261QA1903X
License
261QA1903X Issued in NY
Legal business name
PARKMED, LLC
Practice address
800 2ND Ave
New York, NY 10017-4709
Phone
(212) 686-6402
Fax
(212) 779-7724
NPI assigned
Nov 24, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 19, 2008

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

Authorized official

Name
Mr. Ann Maberry
Title
Financial Director
Phone
(212) 686-6402

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Ambulatory Surgical Clinic/Center 261QA1903X 261QA1903X NY Primary

Addresses

Primary practice location

800 2ND Ave
New York, NY 10017-4709

Mailing address

800 2ND Ave
New York, NY 10017-4709
Phone (212) 686-6402

Other identifiers 1

IdentifierTypeStateIssuer
01995519MedicaidNY

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1164326400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1203379200000",
    "number": "1104992072",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "800 2ND AVE",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100174709",
            "telephone_number": "212-686-6402",
            "fax_number": "212-779-7724"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "800 2ND AVE",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100174709",
            "telephone_number": "212-686-6402",
            "fax_number": "212-779-7724"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PARKMED, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-24",
        "last_updated": "2008-02-19",
        "status": "A",
        "authorized_official_last_name": "MABERRY",
        "authorized_official_first_name": "ANN",
        "authorized_official_title_or_position": "FINANCIAL DIRECTOR",
        "authorized_official_telephone_number": "212-686-6402",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "261QA1903X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ambulatory Surgical",
            "state": "NY",
            "license": "261QA1903X",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01995519",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 19, 2008; 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.