Juan-Diego Harris, MD

Primary specialty

Interventional Pain Medicine PhysicianTaxonomy code 208VP0014X

License

001531 Issued in NY

Practice address

3 Lyon PL
Ogdensburg, NY 13669-2590

Phone

(315) 394-7542

Fax

(315) 394-0015

NPI assigned

Nov 11, 2005

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

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.

• Montefiore Medical Center

  • Anesthesiology Physician
  • Bronx, NY
  • NPI 1063525152
  NPD (past)

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

{
    "created_epoch": "1131667200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1576108800000",
    "number": "1306827654",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3 LYON PL",
            "city": "OGDENSBURG",
            "state": "NY",
            "postal_code": "136692590",
            "telephone_number": "315-394-7542",
            "fax_number": "315-394-0015"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3 LYON PL",
            "city": "OGDENSBURG",
            "state": "NY",
            "postal_code": "136692590",
            "telephone_number": "315-394-7542",
            "fax_number": "315-394-0015"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HARRIS",
        "first_name": "JUAN-DIEGO",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-11-11",
        "last_updated": "2019-12-12",
        "certification_date": "2019-12-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207LP2900X",
            "taxonomy_group": "",
            "desc": "Anesthesiology, Pain Medicine",
            "state": "NY",
            "license": "X001531-1",
            "primary": false
        },
        {
            "code": "208VP0014X",
            "taxonomy_group": "",
            "desc": "Pain Medicine, Interventional Pain Medicine",
            "state": "NY",
            "license": "001531",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PTAN",
            "identifier": "RB6019",
            "state": "NY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02375226",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Terry Hanna
• Tina Hanna
• Sabrina Lynn Hare, RN
• Lisa Marie Harmer I, RN, PSYCHIATRIC
• Cheryl Harper
• Traci-Jo Elizabeth Harris
• Jordan Haskins
• Hillary M Heaton, FNP
• Gordon Leigh Heiss, D.O.
• Emma Deetta Greguire Henry, MA, SLP-CCC

• Interventional Pain Medicine Physician in Ogdensburg, NY
• Providers in Ogdensburg, NY by specialty
• Interventional Pain Medicine Physician in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 12, 2019; 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.