Individual provider Active NPI

Elijah John Emmons

  • Registered Nurse
  • Johnson City, NY
National Provider Identifier
1265299457
Registry record updated Mar 4, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered NurseTaxonomy code 163W00000X
License
818195 Issued in NY
Practice address
156 Corliss Ave
Johnson City, NY 13790-2060
Phone
(607) 763-6735
NPI assigned
Mar 4, 2024
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 4, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 818195 NY Primary

Addresses

Primary practice location

156 Corliss Ave
Johnson City, NY 13790-2060

Mailing address

33 Lewis Rd
Binghamton, NY 13905-1048
Phone (607) 770-0025

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240819002250 NY Practitioner - Certified Registered Nurse Anesthetist (Crna) 1658819883 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 2024
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
United Health Services Hospitals, Inc.Group PAC ID 5193610533, 471 clinicians

Practice addresses (Care Compare)

10 -24 Mitchell Ave
Binghamton, NY 13903-1617
Phone (607) 762-3131

33 -57 Harrison St
Johnson City, NY 13790-2107
Phone (607) 763-6101

52 Harrison St
Johnson City, NY 13790-2120
Phone (607) 763-5898

54 Main St
Candor, NY 13743-1619
Phone (607) 659-7272

Hospital & facility affiliations

  • United Health Services Hospitals, Inc Hospital, Binghamton, NY, CCN 330394

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
818195NYMDRegistered Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
United Health Services Hospitals, Inc. CurrentSince Jun 25, 2024 Accepting new patients

Locations

33 Lewis Rd
Fl 2
Binghamton, NY 13905
Phone (607) 729-8156

33 Lewis Rd
Binghamton, NY 13905
Phone (607) 240-2545

Organizations & group practices 1

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.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1709510400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1709510400000",
    "number": "1265299457",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "33 LEWIS RD",
            "city": "BINGHAMTON",
            "state": "NY",
            "postal_code": "139051048",
            "telephone_number": "607-770-0025"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "156 CORLISS AVE",
            "city": "JOHNSON CITY",
            "state": "NY",
            "postal_code": "137902060",
            "telephone_number": "607-763-6735"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EMMONS",
        "first_name": "ELIJAH",
        "middle_name": "JOHN",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2024-03-04",
        "last_updated": "2024-03-04",
        "certification_date": "2024-03-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "NY",
            "license": "818195",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Johnson City, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 4, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • 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.