NPIMap

Organization Active NPI

Back and Body Medical Care, P.C.

  • Multi-Specialty Clinic/Center
  • New York, NY
National Provider Identifier
1306021274
Registry record updated Nov 15, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Multi-Specialty Clinic/CenterTaxonomy code 261QM1300X
License
245922-1 Issued in NY
Legal business name
BACK AND BODY MEDICAL CARE, P.C.
Practice address
133 E 58TH St
Suite 708
New York, NY 10022-1236
Phone
(212) 371-2000
Fax
(212) 371-2250
NPI assigned
Jan 9, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 15, 2010

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

Authorized official

Name
Dr. Shan Sivendra, M.D.NPI 1538154307
Title
President
Phone
(212) 371-2000

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Multi-Specialty Clinic/Center 261QM1300X 245922-1 NY Primary

Addresses

Primary practice location

133 E 58TH St
Suite 708
New York, NY 10022-1236

Mailing address

133 E 58TH St
Suite 708
New York, NY 10022-1236
Phone (212) 371-2000

Other names 1

  • dba Back and Body Medical Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20100317000006 NY Part B Supplier - Clinic/Group Practice 6709911753 Receives reassigned benefits from 10 practitioners
Practice locations: New York, NY

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 10

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1199836800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1289779200000",
    "number": "1306021274",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "133 E 58TH ST",
            "address_2": "SUITE 708",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100221236",
            "telephone_number": "212-371-2000",
            "fax_number": "212-371-2250"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "133 E 58TH ST",
            "address_2": "SUITE 708",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100221236",
            "telephone_number": "212-371-2000",
            "fax_number": "212-371-2250"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BACK AND BODY MEDICAL CARE, P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-01-09",
        "last_updated": "2010-11-15",
        "status": "A",
        "authorized_official_last_name": "SIVENDRA",
        "authorized_official_first_name": "SHAN",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "212-371-2000",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "261QM1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Multi-Specialty",
            "state": "NY",
            "license": "245922-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "dba Back and Body Medical",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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 Nov 15, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.