Individual provider Active NPI

Jonathan Plaut, M.D.

  • Anesthesiology Physician
  • Suffern, NY
National Provider Identifier
1245647015
Registry record updated Sep 7, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
License
295497 Issued in NY
Practice address
255 Lafayette Ave
Suffern, NY 10901
Phone
(845) 368-5039
Fax
(845) 368-5327
NPI assigned
Jul 14, 2014
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 7, 2018

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology Physician 207L00000X 25MA10403900 NJ
Anesthesiology Physician 207L00000X 295497 NY Primary

Addresses

Primary practice location

255 Lafayette Ave
Suffern, NY 10901

Mailing address

450 Clarkson Ave # MSC6
Brooklyn, NY 11203-2012

Other identifiers 1

IdentifierTypeStateIssuer
PENDINGOtherNYNY MEDICARE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY, NJ2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20180926002637 NY Practitioner - Anesthesiology 9638420862 Reassigns benefits to 2 organizations
I20210414001647 NJ Practitioner - Anesthesiology 9638420862

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
25MA10403900NJMDAnesthesiology Physician
295497NYMDAnesthesiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Kavanah Medical PLLC Current Accepting new patients
Ramapo Anesthesiologists, PC Anesthesiology CurrentSince Sep 24, 2018 Accepting new patients
Downtown Bronx Medical Associates PC CurrentSince Mar 1, 2020 Accepting new patients

Locations

234 Eugenio Maria de Hosto Blvd
Bronx, NY 10451
Phone (718) 579-5874

160 E Main St
Port Jervis, NY 12771
Phone (845) 856-7000

100 Route 59
Ste 111
Suffern, NY 10901
Phone (845) 369-9701

255 Lafayette Ave
Suffern, NY 10901
Phone (845) 357-7830

233 Lafayette Ave
Ste LL5
Suffern, NY 10901
Phone (914) 794-7741

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1405296000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1536278400000",
    "number": "1245647015",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "450 CLARKSON AVE # MSC6",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112032012"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "255 LAFAYETTE AVE",
            "city": "SUFFERN",
            "state": "NY",
            "postal_code": "10901",
            "telephone_number": "845-368-5039",
            "fax_number": "845-368-5327"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PLAUT",
        "first_name": "JONATHAN",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-07-14",
        "last_updated": "2018-09-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "NJ",
            "license": "25MA10403900",
            "primary": false
        },
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "NY",
            "license": "295497",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NY MEDICARE",
            "identifier": "PENDING",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Suffern, NY

Sources for this page

Verify at the official NPI Registry.