Organization Active NPI

Joel Bruce Fieldman MD P.C.

  • Anesthesiology Physician
  • Roslyn Heights, NY
National Provider Identifier
1174719769
Registry record updated Nov 20, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
License
193719 Issued in NY
Legal business name
JOEL BRUCE FIELDMAN MD P.C.
Practice address
40 Turf LN
Roslyn Heights, NY 11577-2738
Phone
(718) 416-4389
Fax
(718) 416-3652
NPI assigned
Sep 18, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 20, 2013

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

Authorized official

Name
Ms. Leticia Cotto
Title
Adminstrator
Phone
(718) 416-4389

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207L00000X 193719 NY Primary

Addresses

Primary practice location

40 Turf LN
Roslyn Heights, NY 11577-2738

Mailing address

40 Turf LN
Roslyn Heights, NY 11577-2738
Phone (718) 416-4389

Other identifiers 3

IdentifierTypeStateIssuer
G100080710OtherNYMEDICARE PTAN
A100078038OtherNYMEDICARE PTAN
0154T1OtherNYMEDICARE PIN OTHER

Medicare participation

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

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20121207000040 NY Part B Supplier - Clinic/Group Practice 1951553411 Receives reassigned benefits from 2 practitioners
Practice locations: Ny, NY; Valley Stream, NY
O20121207000131 NY Part B Supplier - Clinic/Group Practice 1951553411 Receives reassigned benefits from 2 practitioners
Practice locations: Forest Hills, NY; Fresh Meadows, NY

National Provider Directory

National Provider Directory

Locations

11204 Queens Blvd
Forest Hills, NY 11375
Phone (718) 263-6083

18904 Union Tpke
Fresh Meadows, NY 11366
Phone (718) 217-1414

Practitioners & affiliated clinicians

Practitioners 15

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

View all 15

NPI Registry JSON

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

{
    "created_epoch": "1190073600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1384905600000",
    "number": "1174719769",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "40 TURF LN",
            "city": "ROSLYN HEIGHTS",
            "state": "NY",
            "postal_code": "115772738",
            "telephone_number": "718-416-4389",
            "fax_number": "718-416-3652"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "40 TURF LN",
            "city": "ROSLYN HEIGHTS",
            "state": "NY",
            "postal_code": "115772738",
            "telephone_number": "718-416-4389",
            "fax_number": "718-416-3652"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JOEL BRUCE FIELDMAN MD P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-09-18",
        "last_updated": "2013-11-20",
        "status": "A",
        "authorized_official_last_name": "COTTO",
        "authorized_official_first_name": "LETICIA",
        "authorized_official_title_or_position": "ADMINSTRATOR",
        "authorized_official_telephone_number": "718-416-4389",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Anesthesiology",
            "state": "NY",
            "license": "193719",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PTAN",
            "identifier": "G100080710",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PTAN",
            "identifier": "A100078038",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PIN OTHER",
            "identifier": "0154T1",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Roslyn Heights, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 20, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.