Ellinwood Pediatrics PLLC

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

172945 Issued in NY

Legal business name

ELLINWOOD PEDIATRICS PLLC

Practice address

600 French Rd Ste 3
New Hartford, NY 13413-1037

Phone

(315) 725-2773

Fax

(315) 316-0501

NPI assigned

Jun 4, 2014

Last updated

Oct 24, 2024By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Kathy-Ann Carol Irish-Benjamin, MDNPI 1518939305

Title

Owner

Phone

(315) 725-2773

Specialties & licenses 1

Addresses

Locations

Practitioners 1

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.

• Kathy-Ann Carol Irish-Benjamin, MD

  • Pediatrics Physician
  • New Hartford, NY
  • NPI 1518939305
  Authorized official Same address or phone

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

{
    "created_epoch": "1401840000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1729728000000",
    "number": "1245643501",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "600 FRENCH RD STE 3",
            "city": "NEW HARTFORD",
            "state": "NY",
            "postal_code": "134131037",
            "telephone_number": "315-725-2773",
            "fax_number": "315-316-0501"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "600 FRENCH RD STE 3",
            "city": "NEW HARTFORD",
            "state": "NY",
            "postal_code": "134131037",
            "telephone_number": "315-725-2773",
            "fax_number": "315-316-0501"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ELLINWOOD PEDIATRICS PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-06-04",
        "last_updated": "2024-10-24",
        "certification_date": "2024-10-24",
        "status": "A",
        "authorized_official_last_name": "IRISH-BENJAMIN",
        "authorized_official_first_name": "KATHY-ANN",
        "authorized_official_middle_name": "CAROL",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "315-725-2773",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Pediatrics",
            "state": "NY",
            "license": "172945",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Pediatrics Physician in New Hartford, NY
• Providers in New Hartford, 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 24, 2024; 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.