Adam Bear
Individual provider Active NPI Periodontics · Mamaroneck, NY
NPI 1215344973 · NPPES record last updated Jul 15, 2014
Key facts
- NPI
- 1215344973
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Periodontics 1223P0300X
- License
- 057299 (NY)
- Practice address
- 515 Halstead Ave
Mamaroneck, NY 10543-2715 - Phone
- (914) 777-9465
- NPI assigned
- Jul 15, 2014
- Sex
- Male
- Sole proprietor
- Yes
Organizations & group practices 2
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in NY
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: No · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20191010002182 | NY | Order and Referring Only - Dentist |
4880925585 |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 057299 | NY | MD | Periodontist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Singular Anesthesia Services, PLLC | Past | Accepting new patients | |
| One Endo Support Services | Past |
Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Periodontics | 1223P0300X | 057299 | NY | Yes |
Addresses
Primary practice location
515 Halstead Ave
Mamaroneck, NY 10543-2715
Mailing address
9801 67TH Ave Apt 11X
Rego Park, NY 11374-4911
Phone (631) 942-9232
Other providers in Mamaroneck, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 15, 2014. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.