Individual provider Active NPI

Minas C Joannides III

  • Internal Medicine Physician
  • Somers, NY
National Provider Identifier
1114438868
Registry record updated Oct 21, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
203147 Issued in NY
Practice address
175 Arbor CRST
Somers, NY 10589-1809
Phone
(914) 261-6281
Fax
(914) 277-1721
NPI assigned
Oct 21, 2017
Last updated
Oct 21, 2017By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 21, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 203147 NY Primary

Addresses

Primary practice location

175 Arbor CRST
Somers, NY 10589-1809

Mailing address

175 Arbor CRST
Somers, NY 10589-1809
Phone (914) 261-6281

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

LicenseStateTypeSpecialty
203147NYMDInternal Medicine Physician

NPI Registry JSON

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

{
    "created_epoch": "1508544000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1508544000000",
    "number": "1114438868",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "175 ARBOR CRST",
            "city": "SOMERS",
            "state": "NY",
            "postal_code": "105891809",
            "telephone_number": "914-261-6281",
            "fax_number": "914-277-1721"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "175 ARBOR CRST",
            "city": "SOMERS",
            "state": "NY",
            "postal_code": "105891809",
            "telephone_number": "914-261-6281",
            "fax_number": "914-277-1721"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOANNIDES",
        "first_name": "MINAS",
        "middle_name": "C",
        "name_suffix": "III",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2017-10-21",
        "last_updated": "2017-10-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NY",
            "license": "203147",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Somers, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 21, 2017; 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.