Individual provider Active NPI

Sean Patrick Holdridge, MD

  • Pediatrics Physician
  • Binghamton, NY
National Provider Identifier
1134457583
Registry record updated Mar 18, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
254688 Issued in NY
Practice address
161 Riverside Dr
Suite 206
Binghamton, NY 13905-4176
Phone
(607) 798-6176
NPI assigned
Nov 23, 2009
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 18, 2021

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X MD438211 PA
Pediatrics Physician 208000000X A105707 CA
Pediatrics Physician 208000000X 254688 NY Primary

Addresses

Primary practice location

161 Riverside Dr
Suite 206
Binghamton, NY 13905-4176

Mailing address

161 Riverside Dr
Suite 206
Binghamton, NY 13905-4176
Phone (607) 798-6176

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address sean.holdridge@direct.lourdes.com Direct

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: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20111014000412 NY Practitioner - Pediatric Medicine 9133391246 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
A105707CAMDPediatrics Physician
254688NYMDPediatrics Physician
MD438211PAMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Twin Tier Pathology Associates, PC Current Accepting new patients
Our Lady of Lourdes Memorial Hospital, Inc. CurrentSince Sep 4, 2011 Accepting new patients
Our Lady of Lourdes Memorial Hospital, Inc. CurrentSince Sep 4, 2011 Accepting new patients
Our Lady of Lourdes Memorial Hospital Inc. Current Accepting new patients

Locations

169 Riverside Dr
Binghamton, NY 13905
Phone (607) 798-5111

161 Riverside Dr
Ste 205
Binghamton, NY 13905
Phone (607) 798-6176

161 Riverside Dr
Ste 206
Binghamton, NY 13905
Phone (607) 798-6176

169 Riverside Dr
Ste 206
Binghamton, NY 13905
Phone (607) 798-6701

Interoperability endpoints

  • Direct secure messaging: sholdridge196043@direct-guthrie.org

Organizations & group practices 4

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": "1258934400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1616025600000",
    "number": "1134457583",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "161 RIVERSIDE DR",
            "address_2": "SUITE 206",
            "city": "BINGHAMTON",
            "state": "NY",
            "postal_code": "139054176",
            "telephone_number": "607-798-6176"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "161 RIVERSIDE DR",
            "address_2": "SUITE 206",
            "city": "BINGHAMTON",
            "state": "NY",
            "postal_code": "139054176",
            "telephone_number": "607-798-6176"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HOLDRIDGE",
        "first_name": "SEAN",
        "middle_name": "PATRICK",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2009-11-23",
        "last_updated": "2021-03-18",
        "certification_date": "2021-03-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "PA",
            "license": "MD438211",
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "CA",
            "license": "A105707",
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "NY",
            "license": "254688",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "sean.holdridge@direct.lourdes.com",
            "affiliation": "N",
            "endpointDescription": "Lourdes Hospital",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "CCDA",
            "address_1": "169 Riverside Dr",
            "city": "Binghamton",
            "state": "NY",
            "country_code": "US",
            "postal_code": "139054246",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Binghamton, NY

Sources for this page

Verify at the official NPI Registry.