Organization Active NPI

Hudson Valley Pain Management, PLLC

  • Pain Medicine (Anesthesiology) Physician
  • Yorktown Heights, NY
National Provider Identifier
1124327861
Registry record updated Mar 21, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pain Medicine (Anesthesiology) PhysicianTaxonomy code 207LP2900X
License
244335 Issued in NY
Legal business name
HUDSON VALLEY PAIN MANAGEMENT, PLLC
Practice address
1940 Commerce St
Suite 212
Yorktown Heights, NY 10598-4428
Phone
(914) 245-3060
Fax
(914) 245-3065
NPI assigned
Mar 21, 2011
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 21, 2011

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

Authorized official

Name
Dr. Christian K Piccolo, MDNPI 1447485792
Title
Owner
Phone
(914) 245-3060

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pain Medicine (Anesthesiology) PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207LP2900X 244335 NY Primary

Addresses

Primary practice location

1940 Commerce St
Suite 212
Yorktown Heights, NY 10598-4428

Mailing address

1940 Commerce St
Suite 212
Yorktown Heights, NY 10598-4428
Phone (914) 245-3060

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20110412000272 NY Part B Supplier - Clinic/Group Practice 5991989204 Receives reassigned benefits from 1 practitioner
Practice locations: Yorktown Heights, NY; Croton on Hudson, NY; Mohegan Lake, NY
O20131202000133 NY DME Supplier - Physician - Interventional Pain Management 5991989204 Practice locations: Yorktown Heights, NY

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
33D2022398Hudson Valley Pain Management PLLC1940 Commerce Street Suite 212, Yorktown Heights, NY 10598Certificate of waiverMar 9, 2028

National Provider Directory

National Provider Directory

Locations

1280 Albany Post Rd
Croton on Hudson, NY 10520
Phone (914) 271-5151

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1300665600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1300665600000",
    "number": "1124327861",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1940 COMMERCE ST",
            "address_2": "SUITE 212",
            "city": "YORKTOWN HEIGHTS",
            "state": "NY",
            "postal_code": "105984428",
            "telephone_number": "914-245-3060",
            "fax_number": "914-245-3065"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1940 COMMERCE ST",
            "address_2": "SUITE 212",
            "city": "YORKTOWN HEIGHTS",
            "state": "NY",
            "postal_code": "105984428",
            "telephone_number": "914-245-3060",
            "fax_number": "914-245-3065"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HUDSON VALLEY PAIN MANAGEMENT, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-03-21",
        "last_updated": "2011-03-21",
        "status": "A",
        "authorized_official_last_name": "PICCOLO",
        "authorized_official_first_name": "CHRISTIAN",
        "authorized_official_middle_name": "K",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "914-245-3060",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207LP2900X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Anesthesiology, Pain Medicine",
            "state": "NY",
            "license": "244335",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Yorktown Heights, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 21, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.