NPIMap

Organization Active NPI

Northeast Implant & Oral Surgery, PC

  • Oral & Maxillofacial Surgery (D.M.D.)
  • Danbury, CT
National Provider Identifier
1215152574
Registry record updated May 12, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Oral & Maxillofacial Surgery (D.M.D.)Taxonomy code 204E00000X
Legal business name
NORTHEAST IMPLANT & ORAL SURGERY, PC
Practice address
27 Hospital Ave Ste 306
Danbury, CT 06810-5961
Phone
(203) 797-0008
Fax
(203) 743-7822
NPI assigned
Apr 13, 2007
Last updated
May 12, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 12, 2023

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

Authorized official

Name
Monica McCarley
Title
Insurance Coordinator/Credentialing
Phone
(203) 628-4450

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Oral & Maxillofacial Surgery (D.M.D.) 204E00000X Primary

Addresses

Primary practice location

27 Hospital Ave Ste 306
Danbury, CT 06810-5961

Mailing address

27 Hospital Ave Ste 306
Danbury, CT 06810-5961
Phone (203) 628-4450

Other practice location 1

667 Stoneleigh Ave Ste 301
Carmel, NY 10512-2455
Phone (845) 278-2101

Medicare participation

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

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20070427000026 CT Part B Supplier - Clinic/Group Practice 7012013790 Receives reassigned benefits from 3 practitioners
Practice locations: Danbury, CT
O20070427000516 NY Part B Supplier - Clinic/Group Practice 7012013790 Receives reassigned benefits from 8 practitioners
Practice locations: Carmel, NY; Hartsdale, NY; Mount Kisco, NY; Poughkeepsie, NY

National Provider Directory

National Provider Directory

Locations

27 Hospital Ave
Ste 203
Danbury, CT 06810
Phone (203) 797-0008

27 Hospital Ave
Ste 306
Danbury, CT 06810
Phone (203) 797-0008

667 Stoneleigh Ave
Ste 301
Carmel, NY 10512
Phone (845) 278-2101

280 N Central Ave
Ste 207
Hartsdale, NY 10530
Phone (203) 797-0008

666 Lexington Ave
Ste 203
Mount Kisco, NY 10549
Phone (203) 797-0008

43 Lagrange Ave
Poughkeepsie, NY 12603
Phone (845) 452-2900

Practitioners & affiliated clinicians

Practitioners 12

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": "1176422400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1683849600000",
    "number": "1215152574",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "27 HOSPITAL AVE STE 306",
            "city": "DANBURY",
            "state": "CT",
            "postal_code": "068105961",
            "telephone_number": "203-628-4450",
            "fax_number": "203-628-2350"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "27 HOSPITAL AVE STE 306",
            "city": "DANBURY",
            "state": "CT",
            "postal_code": "068105961",
            "telephone_number": "203-797-0008",
            "fax_number": "203-743-7822"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "667 Stoneleigh Ave Ste 301",
            "address_purpose": "LOCATION",
            "city": "Carmel",
            "state": "NY",
            "postal_code": "105122455",
            "country_code": "US",
            "telephone_number": "845-278-2101",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "NORTHEAST IMPLANT & ORAL SURGERY, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-13",
        "last_updated": "2023-05-12",
        "certification_date": "2023-05-12",
        "status": "A",
        "authorized_official_last_name": "MCCARLEY",
        "authorized_official_first_name": "MONICA",
        "authorized_official_title_or_position": "INSURANCE COORDINATOR/CREDENTIALING",
        "authorized_official_telephone_number": "203-628-4450"
    },
    "taxonomies": [
        {
            "code": "204E00000X",
            "taxonomy_group": "",
            "desc": "Oral & Maxillofacial Surgery",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Danbury, CT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 12, 2023; 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.