Individual provider Active NPI

Eric William Small, MD

  • Pediatric Sports Medicine Physician
  • Hartsdale, NY
National Provider Identifier
1336295187
Registry record updated Oct 11, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Sports Medicine PhysicianTaxonomy code 2080S0010X
License
185155 Issued in NY
Practice address
280 N Central Ave Ste 70
Hartsdale, NY 10530-1835
Phone
(914) 666-7900
Fax
(914) 666-7901
NPI assigned
Jan 26, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 11, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Sports Medicine Physician 2080S0010X 185155 NY Primary

Addresses

Primary practice location

280 N Central Ave Ste 70
Hartsdale, NY 10530-1835

Mailing address

280 N Central Ave Ste 70
Hartsdale, NY 10530-1835
Phone (914) 666-7900

Other practice location 1

280 N Central Ave Ste 70
Hartsdale, NY 10530-1835
Phone (914) 666-7900

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.
Opted out of Medicare
Yes, effective Jul 19, 2019 through Jul 19, 2027

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
185155NYMDPediatric Sports Medicine Physician

Networks

  • Healthfirst Medicare Network H9678
  • Healthfirst Medicare Network H1722
  • Healthfirst Medicare Network H5989
  • Healthfirst Medicare Network H3359

NPI Registry JSON

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

{
    "created_epoch": "1169769600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1570752000000",
    "number": "1336295187",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "280 N CENTRAL AVE STE 70",
            "city": "HARTSDALE",
            "state": "NY",
            "postal_code": "105301835",
            "telephone_number": "914-666-7900",
            "fax_number": "914-666-7901"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "280 N CENTRAL AVE STE 70",
            "city": "HARTSDALE",
            "state": "NY",
            "postal_code": "105301835",
            "telephone_number": "914-666-7900",
            "fax_number": "914-666-7901"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "280 N Central Ave Ste 70",
            "address_purpose": "LOCATION",
            "city": "Hartsdale",
            "state": "NY",
            "postal_code": "105301835",
            "country_code": "US",
            "telephone_number": "914-666-7900",
            "fax_number": "914-666-7901",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SMALL",
        "first_name": "ERIC",
        "middle_name": "WILLIAM",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-01-26",
        "last_updated": "2019-10-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2080S0010X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Sports Medicine",
            "state": "NY",
            "license": "185155",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hartsdale, NY

Sources for this page

Verify at the official NPI Registry.