Organization Active NPI

Maternity Medical Group PLLC

  • Obstetrics Physician
  • New York, NY
National Provider Identifier
1336716059
Registry record updated Jan 5, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics PhysicianTaxonomy code 207VX0000X
Legal business name
MATERNITY MEDICAL GROUP PLLC
Practice address
101 W 12TH St
New York, NY 10011-8142
Phone
(212) 705-8785
Fax
(212) 370-4390
NPI assigned
Jun 10, 2021
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 5, 2023

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

Authorized official

Name
Jaqueline M Worth, MDNPI 1619971975
Title
Manager
Phone
(212) 741-2229

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 3

Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics & Gynecology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207V00000X
Obstetrics PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207VX0000X Primary
Advanced Practice MidwifeGroup: 193200000X MULTI-SPECIALTY GROUP 367A00000X

Addresses

Primary practice location

101 W 12TH St
New York, NY 10011-8142

Mailing address

1225 Park Ave # 1D
New York, NY 10128-1758
Phone (212) 741-2229

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": "1623283200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1672876800000",
    "number": "1336716059",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1225 PARK AVE # 1D",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "101281758",
            "telephone_number": "212-741-2229",
            "fax_number": "212-741-2228"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "101 W 12TH ST",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100118142",
            "telephone_number": "212-705-8785",
            "fax_number": "212-370-4390"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MATERNITY MEDICAL GROUP PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-06-10",
        "last_updated": "2023-01-05",
        "certification_date": "2023-01-05",
        "status": "A",
        "authorized_official_last_name": "WORTH",
        "authorized_official_first_name": "JAQUELINE",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "212-741-2229",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Obstetrics & Gynecology",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207VX0000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Obstetrics & Gynecology, Obstetrics",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "367A00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Advanced Practice Midwife",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "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 5, 2023; 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.