Active NPI
Theodore Steils
- Physician Assistant
- Claverack, NY
National Provider Identifier
1356717896
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- License
- 005654
- Practice address
- 419 Spook Rock Rd
Claverack, NY 12513 - Phone
- (518) 851-3211
- NPI assigned
- Aug 19, 2015
- Last updated
- Aug 19, 2015
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | 005654 | NY | Primary |
Addresses
Primary practice location
419 Spook Rock Rd
Claverack, NY 12513
Mailing address
PO Box 265
Brookwood Secure Center
Claverack, NY 12513-0265
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 005654 | NY | MD | Clinical Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1439942400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1439942400000",
"number": "1356717896",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 265",
"address_2": "BROOKWOOD SECURE CENTER",
"city": "CLAVERACK",
"state": "NY",
"postal_code": "125130265"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "419 SPOOK ROCK RD",
"city": "CLAVERACK",
"state": "NY",
"postal_code": "12513",
"telephone_number": "518-851-3211"
}
],
"practiceLocations": [],
"basic": {
"last_name": "STEILS",
"first_name": "THEODORE",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2015-08-19",
"last_updated": "2015-08-19",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "NY",
"license": "005654",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Claverack, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 19, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.