Organization Active NPI

Northeast Orthopedics and Sports Medicine PLLC

  • Durable Medical Equipment & Medical Supplies
  • Stony Point, NY
National Provider Identifier
1295150068
Registry record updated Mar 3, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X
Legal business name
NORTHEAST ORTHOPEDICS AND SPORTS MEDICINE PLLC
Practice address
25 Liberty Square Mall
Stony Point, NY 10980-2400
Phone
(845) 356-2900
Fax
(845) 786-1950
NPI assigned
Mar 3, 2014
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 3, 2014

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

Authorized official

Name
Jordan A Simon, MD
Title
Owner
Phone
(845) 359-1877

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Durable Medical Equipment & Medical Supplies 332B00000X NY Primary

Addresses

Primary practice location

25 Liberty Square Mall
Stony Point, NY 10980-2400

Mailing address

25 Liberty Square Mall
Stony Point, NY 10980-2400
Phone (845) 356-2900

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1393804800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1393804800000",
    "number": "1295150068",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "25 LIBERTY SQUARE MALL",
            "city": "STONY POINT",
            "state": "NY",
            "postal_code": "109802400",
            "telephone_number": "845-356-2900",
            "fax_number": "845-786-1950"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "25 LIBERTY SQUARE MALL",
            "city": "STONY POINT",
            "state": "NY",
            "postal_code": "109802400",
            "telephone_number": "845-356-2900",
            "fax_number": "845-786-1950"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NORTHEAST ORTHOPEDICS AND SPORTS MEDICINE PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-03-03",
        "last_updated": "2014-03-03",
        "status": "A",
        "authorized_official_last_name": "SIMON",
        "authorized_official_first_name": "JORDAN",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "845-359-1877",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "NY",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Stony Point, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 3, 2014; 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.