Island Pediatrics, P.C.

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

168902 Issued in NY

Legal business name

ISLAND PEDIATRICS, P.C.

Practice address

125 Slosson Ave
Staten Island, NY 10314-2517

Phone

(718) 390-0400

Fax

(718) 390-0566

NPI assigned

Oct 17, 2012

Organization subpart

No

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

Authorized official

Name

Dr. Brian Robert McMahon, M.D.NPI 1457325607

Title

President

Phone

(719) 390-0400

Specialties & licenses 1

Addresses

Other identifiers 1

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Practitioners 2

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

• Brian R McMahon, M.D.

  • Pediatrics Physician
  • Staten Island, NY
  • NPI 1457325607
  NPD (past) Authorized official
• Victoria Colasurdo, PA-C

  • Physician Assistant
  • Staten Island, NY
  • NPI 1568032381
  NPD (past)

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

{
    "created_epoch": "1350432000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1350432000000",
    "number": "1245583137",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "125 SLOSSON AVE",
            "city": "STATEN ISLAND",
            "state": "NY",
            "postal_code": "103142517",
            "telephone_number": "718-390-0400",
            "fax_number": "718-390-0566"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "125 SLOSSON AVE",
            "city": "STATEN ISLAND",
            "state": "NY",
            "postal_code": "103142517",
            "telephone_number": "718-390-0400",
            "fax_number": "718-390-0566"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ISLAND PEDIATRICS, P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-10-17",
        "last_updated": "2012-10-17",
        "status": "A",
        "authorized_official_last_name": "MCMAHON",
        "authorized_official_first_name": "BRIAN",
        "authorized_official_middle_name": "ROBERT",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "719-390-0400",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Pediatrics",
            "state": "NY",
            "license": "168902",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01848993",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Island Medical Specialists, P.L.L.C.
• Island Men'S Medical Health Practice, PC
• Island Nephrology Services, PC
• Island Nurse Practitioner in Family Health, PLLC
• Island Obstetrics and Gynecology
• Island Professional Acupuncture PC
• Island Rehab PT OT PLLC
• Island Rehabilitative Services Corp
• Island Rehabilitative Services Corp.
• Island Reproductive Services, PC

• Pediatrics Physician in Staten Island, NY
• Providers in Staten Island, NY by specialty
• Pediatrics Physician in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 17, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.