NPIMap

Organization Active NPI

Great Bay Neurosurgical Associates, P.a.

  • Neurological Surgery Physician
  • Dover, NH
National Provider Identifier
1194950840
Registry record updated May 26, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neurological Surgery PhysicianTaxonomy code 207T00000X
Legal business name
GREAT BAY NEUROSURGICAL ASSOCIATES, P.A.
Practice address
750 Central Avenue - Suite H
Great Bay Neurosurgical Associates, P.a.
Dover, NH 03820-3434
Phone
(603) 749-0888
Fax
(603) 749-9285
NPI assigned
May 26, 2009
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 26, 2009

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

Authorized official

Name
Melvin E. Prostkoff, M.D.NPI 1255566907
Title
President/Ceo/Chairman of Board/Sol
Phone
(603) 749-0888

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Neurological Surgery PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207T00000X Primary

Addresses

Primary practice location

750 Central Avenue - Suite H
Great Bay Neurosurgical Associates, P.a.
Dover, NH 03820-3434

Mailing address

750 Central Avenue - Suite H
Great Bay Neurosurgical Associates, P.a.
Dover, NH 03820-3434
Phone (603) 749-0888

National Provider Directory

National Provider Directory

Locations

750 Central Ave
Ste H
Dover, NH 03820
Phone (603) 749-0888

Practitioners & affiliated clinicians

Practitioners 1

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

NPI Registry JSON

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

{
    "created_epoch": "1243296000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1243296000000",
    "number": "1194950840",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "750 CENTRAL AVENUE - SUITE H",
            "address_2": "GREAT BAY NEUROSURGICAL ASSOCIATES, P.A.",
            "city": "DOVER",
            "state": "NH",
            "postal_code": "038203434",
            "telephone_number": "603-749-0888",
            "fax_number": "603-749-9285"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "750 CENTRAL AVENUE - SUITE H",
            "address_2": "GREAT BAY NEUROSURGICAL ASSOCIATES, P.A.",
            "city": "DOVER",
            "state": "NH",
            "postal_code": "038203434",
            "telephone_number": "603-749-0888",
            "fax_number": "603-749-9285"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GREAT BAY NEUROSURGICAL ASSOCIATES, P.A.",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-05-26",
        "last_updated": "2009-05-26",
        "status": "A",
        "authorized_official_last_name": "PROSTKOFF",
        "authorized_official_first_name": "MELVIN",
        "authorized_official_middle_name": "E.",
        "authorized_official_title_or_position": "PRESIDENT/CEO/CHAIRMAN OF BOARD/SOL",
        "authorized_official_telephone_number": "603-749-0888",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207T00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Neurological Surgery",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Dover, NH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 26, 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.