Organization Active NPI

Orthopedic Surgery & Sports Medicine PC

  • Orthopaedic Surgery Physician
  • Ithaca, NY
National Provider Identifier
1336236884
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthopaedic Surgery PhysicianTaxonomy code 207X00000X
License
1346861 Issued in NY
Legal business name
ORTHOPEDIC SURGERY & SPORTS MEDICINE PC
Practice address
1301 Trumansburg Rd
Suite R
Ithaca, NY 14850-1397
Phone
(607) 272-7000
Fax
(607) 272-4604
NPI assigned
Oct 6, 2006
Last updated
Aug 22, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Dr. Dirk H Dugan, MDNPI 1699854208
Title
President Cfo
Phone
(607) 272-7000

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
Orthopaedic Surgery Physician 207X00000X 1346861 NY Primary

Addresses

Primary practice location

1301 Trumansburg Rd
Suite R
Ithaca, NY 14850-1397

Mailing address

1301 Trumansburg Rd
Suite R
Ithaca, NY 14850-1397
Phone (607) 272-7000

Other identifiers 3

IdentifierTypeStateIssuer
000910746001OtherNYHEALTHNOW
00722803MedicaidNY
4217146OtherNYAETNA

National Provider Directory

National Provider Directory

Locations

1301 Trumansburg Rd
Ste R
Ithaca, NY 14850
Phone (607) 272-7000

Practitioners & affiliated clinicians

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1160092800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1336236884",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1301 TRUMANSBURG RD",
            "address_2": "SUITE R",
            "city": "ITHACA",
            "state": "NY",
            "postal_code": "148501397",
            "telephone_number": "607-272-7000",
            "fax_number": "607-272-4604"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1301 TRUMANSBURG RD",
            "address_2": "SUITE R",
            "city": "ITHACA",
            "state": "NY",
            "postal_code": "148501397",
            "telephone_number": "607-272-7000",
            "fax_number": "607-272-4604"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ORTHOPEDIC SURGERY & SPORTS MEDICINE PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-06",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "DUGAN",
        "authorized_official_first_name": "DIRK",
        "authorized_official_middle_name": "H",
        "authorized_official_title_or_position": "PRESIDENT CFO",
        "authorized_official_telephone_number": "607-272-7000",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207X00000X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery",
            "state": "NY",
            "license": "1346861",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTHNOW",
            "identifier": "000910746001",
            "state": "NY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00722803",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "4217146",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Ithaca, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.