Active NPI
Lauren Selph, MD
- Pediatrics Physician
- New York, NY
National Provider Identifier
1265640221
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatrics Physician
- License
- 27142
- Practice address
- 590 Avenue of the Americas
New York, NY 10011-2019 - Phone
- (646) 459-3609
- NPI assigned
- May 21, 2007
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatrics Physician | 208000000X | 27142 | AL | Primary |
Addresses
Primary practice location
590 Avenue of the Americas
New York, NY 10011-2019
Mailing address
109 E 29TH St
Brooklyn, NY 11226-5505
Phone (646) 459-3609
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 27142 | AL | MD | Pediatrics Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Choctaw Nation of Oklahoma | Past | Accepting new patients |
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.
-
- Primary Care Clinic/Center
- Broken Bow, OK
- NPI 1770559619
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1179705600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1218672000000",
"number": "1265640221",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "109 E 29TH ST",
"city": "BROOKLYN",
"state": "NY",
"postal_code": "112265505",
"telephone_number": "646-459-3609"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "590 AVENUE OF THE AMERICAS",
"city": "NEW YORK",
"state": "NY",
"postal_code": "100112019",
"telephone_number": "646-459-3609"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SELPH",
"first_name": "LAUREN",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-05-21",
"last_updated": "2008-08-14",
"status": "A"
},
"taxonomies": [
{
"code": "208000000X",
"taxonomy_group": "",
"desc": "Pediatrics",
"state": "AL",
"license": "27142",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in New York, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 14, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.