Organization Active NPI

SJR Medical, PC

  • Multi-Specialty Clinic/Center
  • Yonkers, NY
National Provider Identifier
1366468936
Registry record updated May 16, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Multi-Specialty Clinic/CenterTaxonomy code 261QM1300X
Legal business name
SJR MEDICAL, PC
Practice address
1088 North Broadway
Yonkers, NY 10701
Phone
(914) 207-0004
Fax
(914) 965-0107
NPI assigned
Jul 15, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 16, 2025

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

Authorized official

Name
Dr. Paul P. Antonecchia, MDNPI 1437178860
Title
M.D
Phone
(914) 964-4965

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 15

Specialty (taxonomy)CodeLicenseStatePrimary
Registered DietitianGroup: 193200000X MULTI-SPECIALTY GROUP 133V00000X
Family Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207Q00000X
Internal Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207R00000X
Gastroenterology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207RG0100X
Geriatric Medicine (Internal Medicine) PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207RG0300X
Nephrology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207RN0300X
Orthopaedic Surgery PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207X00000X
Pain Medicine (Physical Medicine & Rehabilitation) PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 2081P2900X
Psychiatry PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 2084P0800X
Hospitalist PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 208M00000X
Foot & Ankle Surgery PodiatristGroup: 193200000X MULTI-SPECIALTY GROUP 213ES0103X
Multi-Specialty Clinic/Center 261QM1300X Primary
Physician AssistantGroup: 193200000X MULTI-SPECIALTY GROUP 363A00000X
Nurse PractitionerGroup: 193200000X MULTI-SPECIALTY GROUP 363L00000X
Family Nurse PractitionerGroup: 193200000X MULTI-SPECIALTY GROUP 363LF0000X

Addresses

Primary practice location

1088 North Broadway
Yonkers, NY 10701

Mailing address

PO Box 998
Attn: Riverside Management Services Org
Yonkers, NY 10703-0998
Phone (914) 966-9787

Other practice location 1

1022 North Broadway
Yonkers, NY 10701-1332
Phone (914) 904-4040

Other practice location 2

128 Ashford Avenue
2nd Floor
Dobbs Ferry, NY 10522-1924
Phone (914) 693-6500

Other practice location 3

1019 Yonkers Avenue
Yonkers, NY 10704-3070
Phone (914) 237-1941

Other practice location 4

2 Park Ave
Yonkers, NY 10703-3402
Phone (914) 966-9787 ext. 201

Other practice location 5

141 S. Central Avenue
Ste. 301
Hartsdale, NY 10530-2334
Phone (914) 713-3228

Other identifiers 1

IdentifierTypeStateIssuer
02384247MedicaidNY

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040130000847 NY Part B Supplier - Clinic/Group Practice 5991608440 Receives reassigned benefits from 52 practitioners
Practice locations: Yonkers, NY; Tarrytown, NY; Hartsdale, NY; Dobbs Ferry, NY; Bronxville, NY

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
33D2075539SJR Medical PC St John'S Medical Group141 S Central Ave, Hartsdale, NY 10530Certificate of waiverMar 26, 2027

National Provider Directory

National Provider Directory

Locations

237 W 233rd St
Ofc 1
Bronx, NY 10463
Phone (718) 884-7100

1 Pondfield Rd
Ste 202
Bronxville, NY 10708
Phone (914) 695-2606

77 Pondfield Rd
Ste 2F3A
Bronxville, NY 10708
Phone (914) 771-9286

128 Ashford Ave
#2
Dobbs Ferry, NY 10522
Phone (914) 559-1107

28 Main St
Hastings on Hudson, NY 10706
Phone (914) 693-1982

30 S Highland Ave
Ste A
Ossining, NY 10562
Phone (914) 502-0070

970 N Broadway
Ste 308B
Yonkers, NY 10701
Phone (914) 423-8000

120 Odell Ave
Yonkers, NY 10701
Phone (718) 863-5511

750 McLean Ave
Yonkers, NY 10704
Phone (914) 237-8686

5 Odell Plz
Ste 131
Yonkers, NY 10701
Phone (914) 376-0296

472 Palmer Rd
Fl 1
Yonkers, NY 10701

970 N Broadway
Ste 212
Yonkers, NY 10701
Phone (914) 376-1543

113 S Broadway
Yonkers, NY 10701

1022 N Broadway
Ste 1
Yonkers, NY 10701

967 N Broadway
Fl 5
Yonkers, NY 10701
Phone (914) 964-4631

Practitioners & affiliated clinicians

Practitioners 60

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

View all 60

NPI Registry JSON

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

{
    "created_epoch": "1152921600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1747353600000",
    "number": "1366468936",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 998",
            "address_2": "ATTN: RIVERSIDE MANAGEMENT SERVICES ORG",
            "city": "YONKERS",
            "state": "NY",
            "postal_code": "107030998",
            "telephone_number": "914-966-9787",
            "fax_number": "914-966-9793"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1088 NORTH BROADWAY",
            "city": "YONKERS",
            "state": "NY",
            "postal_code": "10701",
            "telephone_number": "914-207-0004",
            "fax_number": "914-965-0107"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1022 North Broadway",
            "address_purpose": "LOCATION",
            "city": "Yonkers",
            "state": "NY",
            "postal_code": "107011332",
            "country_code": "US",
            "telephone_number": "914-904-4040",
            "fax_number": "914-904-4692",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "128 Ashford Avenue",
            "address_2": "2nd Floor",
            "address_purpose": "LOCATION",
            "city": "Dobbs Ferry",
            "state": "NY",
            "postal_code": "105221924",
            "country_code": "US",
            "telephone_number": "914-693-6500",
            "fax_number": "914-693-2800",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1019 Yonkers Avenue",
            "address_purpose": "LOCATION",
            "city": "Yonkers",
            "state": "NY",
            "postal_code": "107043070",
            "country_code": "US",
            "telephone_number": "914-237-1941",
            "fax_number": "914-207-2420",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2 Park Ave",
            "address_purpose": "LOCATION",
            "city": "Yonkers",
            "state": "NY",
            "postal_code": "107033402",
            "country_code": "US",
            "telephone_number": "914-966-9787 x201",
            "fax_number": "914-966-9793",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "141 S. Central Avenue",
            "address_2": "STE. 301",
            "address_purpose": "LOCATION",
            "city": "Hartsdale",
            "state": "NY",
            "postal_code": "105302334",
            "country_code": "US",
            "telephone_number": "914-713-3228",
            "fax_number": "914-713-3231",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "SJR MEDICAL, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-15",
        "last_updated": "2025-05-16",
        "certification_date": "2025-05-16",
        "status": "A",
        "authorized_official_last_name": "ANTONECCHIA",
        "authorized_official_first_name": "PAUL",
        "authorized_official_middle_name": "P.",
        "authorized_official_title_or_position": "M.D",
        "authorized_official_telephone_number": "914-964-4965",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dietitian, Registered",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207RG0100X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine, Gastroenterology",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207RG0300X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine, Geriatric Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207RN0300X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine, Nephrology",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207X00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Orthopaedic Surgery",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2081P2900X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physical Medicine & Rehabilitation, Pain Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "208M00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Hospitalist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "213ES0103X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Podiatrist, Foot & Ankle Surgery",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QM1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Multi-Specialty",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner, Family",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02384247",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Yonkers, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 16, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.