Organization Active NPI

Pain and Sport Medicine of New York PC

  • Specialist
  • New York, NY
National Provider Identifier
1336260595
Registry record updated Oct 10, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
204326 Issued in NY
Legal business name
PAIN AND SPORT MEDICINE OF NEW YORK PC
Practice address
32 E Broadway RM 501
New York, NY 10002-6891
Phone
(212) 925-8839
Fax
(212) 226-8498
NPI assigned
Apr 3, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 10, 2007

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

Authorized official

Name
Ms. Jane Yang
Title
Billing
Phone
(212) 925-8839

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
SpecialistGroup: 193400000X SINGLE SPECIALTY GROUP 174400000X 204326 NY Primary

Addresses

Primary practice location

32 E Broadway RM 501
New York, NY 10002-6891

Mailing address

32 E 76TH St Apt 804
New York, NY 10021-2754
Phone (212) 925-8839

Other identifiers 6

IdentifierTypeStateIssuer
149219OtherNYWELLCARE
2I2493OtherNYBLUE CROSS BLUE SHIELD
P646923OtherNYOXFORD
10210203OtherNYAMERIGROUP
1888811MedicaidNY
2493590OtherNYAETNA

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

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": "1175558400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1191974400000",
    "number": "1336260595",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "32 E 76TH ST APT 804",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100212754",
            "telephone_number": "212-925-8839",
            "fax_number": "212-226-8498"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "32 E BROADWAY RM 501",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100026891",
            "telephone_number": "212-925-8839",
            "fax_number": "212-226-8498"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PAIN AND SPORT MEDICINE OF NEW YORK PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-03",
        "last_updated": "2007-10-10",
        "status": "A",
        "authorized_official_last_name": "YANG",
        "authorized_official_first_name": "JANE",
        "authorized_official_title_or_position": "BILLING",
        "authorized_official_telephone_number": "212-925-8839",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Specialist",
            "state": "NY",
            "license": "204326",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "WELLCARE",
            "identifier": "149219",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "2I2493",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OXFORD",
            "identifier": "P646923",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AMERIGROUP",
            "identifier": "10210203",
            "state": "NY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1888811",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "2493590",
            "state": "NY"
        }
    ],
    "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 Oct 10, 2007; 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.