Individual provider Active NPI

Barry Ortenberg, DDS

  • Endodontics
  • Coram, NY
National Provider Identifier
1114098076
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
EndodonticsTaxonomy code 1223E0200X
License
031591 Issued in NY
Practice address
248-260 Middle Country Road
Suite 22
Coram, NY 11727-0449
Phone
(631) 736-2525
Fax
(631) 736-6825
NPI assigned
Nov 13, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Endodontics 1223E0200X 031591 NY Primary

Addresses

Primary practice location

248-260 Middle Country Road
Suite 22
Coram, NY 11727-0449

Mailing address

PO Box 449
Coram, NY 11727-0449
Phone (631) 736-2525

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20150605001528 NY Order and Referring Only - DentistPractitioner - Dentist 6204157951

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
031591NYMDMassage Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Barry Ortenberg Gary P Jablow Charles a Baker DDS PC Endodontics 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.

NPI Registry JSON

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

{
    "created_epoch": "1163376000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1114098076",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 449",
            "city": "CORAM",
            "state": "NY",
            "postal_code": "117270449",
            "telephone_number": "631-736-2525",
            "fax_number": "631-736-6825"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "248-260 MIDDLE COUNTRY ROAD",
            "address_2": "SUITE 22",
            "city": "CORAM",
            "state": "NY",
            "postal_code": "117270449",
            "telephone_number": "631-736-2525",
            "fax_number": "631-736-6825"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ORTENBERG",
        "first_name": "BARRY",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-11-13",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223E0200X",
            "taxonomy_group": "",
            "desc": "Dentist, Endodontics",
            "state": "NY",
            "license": "031591",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Coram, NY

Sources for this page

Verify at the official NPI Registry.