Individual provider Active NPI

Indira Elisa Sotomayor, M.S. ED.

  • Specialist
  • New York, NY
National Provider Identifier
1306203476
Registry record updated Jan 20, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
866649 Issued in NY
Practice address
568 Grand St Apt J707
New York, NY 10002-2743
Phone
(917) 450-5170
Fax
(212) 598-4652
NPI assigned
Jan 20, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 20, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X 866649 NY Primary

Addresses

Primary practice location

568 Grand St Apt J707
New York, NY 10002-2743

Mailing address

568 Grand St Apt J707
New York, NY 10002-2743
Phone (917) 450-5170

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
Master of Science

State licenses

LicenseStateTypeSpecialty
866649NYMDSpecialist

NPI Registry JSON

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

{
    "created_epoch": "1453248000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1453248000000",
    "number": "1306203476",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "568 GRAND ST APT J707",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100022743",
            "telephone_number": "917-450-5170",
            "fax_number": "212-598-4652"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "568 GRAND ST APT J707",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100022743",
            "telephone_number": "917-450-5170",
            "fax_number": "212-598-4652"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SOTOMAYOR",
        "first_name": "INDIRA",
        "middle_name": "ELISA",
        "name_prefix": "Mrs.",
        "credential": "M.S. ED.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-01-20",
        "last_updated": "2016-01-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "NY",
            "license": "866649",
            "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 Jan 20, 2016; 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.