Individual provider Active NPI

Louis Ira Siegelman, D.D.S

  • General Practice Dentistry
  • New York, NY
National Provider Identifier
1194822569
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
035940 Issued in NY
Practice address
119 West 57TH Street
Suite 815
New York, NY 10019-2401
Phone
(212) 974-8737
Fax
(212) 247-5350
NPI assigned
Sep 20, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 035940 NY Primary

Addresses

Primary practice location

119 West 57TH Street
Suite 815
New York, NY 10019-2401

Mailing address

119 West 57TH Street
Suite 815
New York, NY 10019-2401
Phone (212) 974-8737

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: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20190814001711 NY Order and Referring Only - DentistPractitioner - Dentist 3577890573

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
035940NYMDPhysical Therapist

NPI Registry JSON

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

{
    "created_epoch": "1158710400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1194822569",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "119 WEST 57TH STREET",
            "address_2": "SUITE 815",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100192401",
            "telephone_number": "212-974-8737",
            "fax_number": "212-247-5350"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "119 WEST 57TH STREET",
            "address_2": "SUITE 815",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100192401",
            "telephone_number": "212-974-8737",
            "fax_number": "212-247-5350"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SIEGELMAN",
        "first_name": "LOUIS",
        "middle_name": "IRA",
        "name_prefix": "Dr.",
        "credential": "D.D.S",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-09-20",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NY",
            "license": "035940",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

Verify at the official NPI Registry.