NPIMap

Organization Active NPI

Northeast Pediatrics & Adolescent Medicine, LLP

  • Pediatrics Physician
  • Ithaca, NY
National Provider Identifier
1184724189
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
Legal business name
NORTHEAST PEDIATRICS & ADOLESCENT MEDICINE, LLP
Practice address
10 Graham Rd W
Ithaca, NY 14850-1055
Phone
(607) 257-2244
Fax
(607) 266-7341
NPI assigned
Sep 22, 2006
Last updated
Aug 22, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Dr. Marugerite Uphoff, MD
Title
Senior Partner
Phone
(607) 257-2244

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X NU Primary

Addresses

Primary practice location

10 Graham Rd W
Ithaca, NY 14850-1055

Mailing address

10 Graham Rd W
Ithaca, NY 14850-1055
Phone (607) 257-2244

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
33D0667583Northeast Pediatrics and Adolescent Medicine, LLP10 Graham Rd West, Ithaca, NY 14850ComplianceJul 31, 2026

National Provider Directory

National Provider Directory

Locations

10 Graham Rd W
Ithaca, NY 14850
Phone (607) 257-2188

Practitioners & affiliated clinicians

Practitioners 17

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.

View all 17

NPI Registry JSON

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

{
    "created_epoch": "1158883200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1184724189",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10 GRAHAM RD W",
            "city": "ITHACA",
            "state": "NY",
            "postal_code": "148501055",
            "telephone_number": "607-257-2244",
            "fax_number": "607-266-7341"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10 GRAHAM RD W",
            "city": "ITHACA",
            "state": "NY",
            "postal_code": "148501055",
            "telephone_number": "607-257-2244",
            "fax_number": "607-266-7341"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NORTHEAST PEDIATRICS & ADOLESCENT MEDICINE, LLP",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-22",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "UPHOFF",
        "authorized_official_first_name": "MARUGERITE",
        "authorized_official_title_or_position": "SENIOR PARTNER",
        "authorized_official_telephone_number": "607-257-2244",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ithaca, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • 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.