NPIMap

Organization Active NPI

Freeport Pain Managment PC.

  • Specialist
  • Freeport, NY
National Provider Identifier
1164751533
Registry record updated Dec 15, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
212687 Issued in NY
Legal business name
FREEPORT PAIN MANAGMENT PC.
Practice address
31 Guy Lombardo Ave
Freeport, NY 11520-3632
Phone
(516) 213-4610
Fax
(516) 213-4819
NPI assigned
Dec 15, 2009
Last updated
Dec 15, 2009By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 15, 2009

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

Authorized official

Name
Mrs. Nidia R Carrero, MD
Title
Pain Managment
Phone
(516) 213-4610

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X 212687 NY Primary

Addresses

Primary practice location

31 Guy Lombardo Ave
Freeport, NY 11520-3632

Mailing address

31 Guy Lombardo Ave
Freeport, NY 11520-3632
Phone (516) 213-4610

Other identifiers 1

IdentifierTypeStateIssuer
02103506MedicaidNY

National Provider Directory

National Provider Directory

Locations

31 Guy Lombardo Ave
Freeport, NY 11520
Phone (516) 213-4610

Practitioners & affiliated clinicians

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1260835200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1260835200000",
    "number": "1164751533",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "31 GUY LOMBARDO AVE",
            "city": "FREEPORT",
            "state": "NY",
            "postal_code": "115203632",
            "telephone_number": "516-213-4610",
            "fax_number": "516-213-4819"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "31 GUY LOMBARDO AVE",
            "city": "FREEPORT",
            "state": "NY",
            "postal_code": "115203632",
            "telephone_number": "516-213-4610",
            "fax_number": "516-213-4819"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FREEPORT PAIN MANAGMENT PC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-12-15",
        "last_updated": "2009-12-15",
        "status": "A",
        "authorized_official_last_name": "CARRERO",
        "authorized_official_first_name": "NIDIA",
        "authorized_official_middle_name": "R",
        "authorized_official_title_or_position": "PAIN MANAGMENT",
        "authorized_official_telephone_number": "516-213-4610",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "NY",
            "license": "212687",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02103506",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Freeport, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 15, 2009; 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.