Clementino Purisima, MD

Primary specialty

General Practice PhysicianTaxonomy code 208D00000X

License

MA03503500 Issued in NJ

Practice address

1005 New York Ave
Union City, NJ 07087-4127

Phone

(201) 863-5065

Fax

(201) 934-1383

NPI assigned

Mar 15, 2007

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in NJ

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

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

{
    "created_epoch": "1173916800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1144354788",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "41 GRISTMILL LN",
            "city": "UPPER SADDLE RIVER",
            "state": "NJ",
            "postal_code": "074581316",
            "telephone_number": "201-863-5065",
            "fax_number": "201-934-1383"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1005 NEW YORK AVE",
            "city": "UNION CITY",
            "state": "NJ",
            "postal_code": "070874127",
            "telephone_number": "201-863-5065",
            "fax_number": "201-934-1383"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PURISIMA",
        "first_name": "CLEMENTINO",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-03-15",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "NJ",
            "license": "MA03503500",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Pro Medquip
• Progressive Medical Imaging of Union City, LLC
• Progressive Pediatrics
• Daisy Pujals, L.S.W.
• Diana L Punales Morejon, PHD
• Jonathan Grecia Purisima, DPM
• R.E.M. Medical
• Raashan C. Williams, MD, Facc, LLC
• Ely Boy Racoma, RPT
• Nency Radadiya

• General Practice Physician in Union City, NJ
• Providers in Union City, NJ by specialty
• General Practice Physician in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.