Organization Active NPI

Pine Street Pediatrics Associates, P.C.

  • Pediatrics Physician
  • Kingston, NY
National Provider Identifier
1225049620
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
Legal business name
PINE STREET PEDIATRICS ASSOCIATES, P.C.
Practice address
140 Pine St Ste 210
Kingston, NY 12401-4948
Phone
(845) 331-4484
Fax
(845) 853-7106
NPI assigned
Aug 10, 2006
Last updated
Jul 21, 2022By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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

Authorized official

Name
Ms. Joanne Hendricks
Title
Billing Coordinator
Phone
(845) 331-4484

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X NY Primary

Addresses

Primary practice location

140 Pine St Ste 210
Kingston, NY 12401-4948

Mailing address

140 Pine St Ste 210
Kingston, NY 12401-4948
Phone (845) 331-4484

National Provider Directory

National Provider Directory

Locations

140 Pine St
Ste 210
Kingston, NY 12401
Phone (845) 331-4484

Practitioners & affiliated clinicians

Practitioners 3

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": "1155168000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1658361600000",
    "number": "1225049620",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "140 PINE ST STE 210",
            "city": "KINGSTON",
            "state": "NY",
            "postal_code": "124014948",
            "telephone_number": "845-331-4484",
            "fax_number": "845-853-7106"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "140 PINE ST STE 210",
            "city": "KINGSTON",
            "state": "NY",
            "postal_code": "124014948",
            "telephone_number": "845-331-4484",
            "fax_number": "845-853-7106"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PINE STREET PEDIATRICS ASSOCIATES, P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-10",
        "last_updated": "2022-07-21",
        "status": "A",
        "authorized_official_last_name": "HENDRICKS",
        "authorized_official_first_name": "JOANNE",
        "authorized_official_title_or_position": "BILLING COORDINATOR",
        "authorized_official_telephone_number": "845-331-4484",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "NY",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Kingston, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; 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.