Individual provider Active NPI

Daniel Timothy Root, MD

  • Family Medicine Physician
  • Lowville, NY
National Provider Identifier
1376533356
Registry record updated Jan 18, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
1649401 Issued in NY
Practice address
7785 N State St
Suite 330
Lowville, NY 13367-1229
Phone
(315) 376-5287
Fax
(315) 376-3228
NPI assigned
Oct 21, 2005
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 18, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 1649401 NY Primary

Addresses

Primary practice location

7785 N State St
Suite 330
Lowville, NY 13367-1229

Mailing address

7785 N State St
Suite 330
Lowville, NY 13367-1229
Phone (315) 376-5287

Other identifiers 1

IdentifierTypeStateIssuer
01178945MedicaidNY

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)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
1649401NYMDFamily Medicine Physician

Interoperability endpoints

  • Direct secure messaging: droot@hiemail.healtheconnections.org

NPI Registry JSON

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

{
    "created_epoch": "1129852800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1358467200000",
    "number": "1376533356",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7785 N STATE ST",
            "address_2": "SUITE 330",
            "city": "LOWVILLE",
            "state": "NY",
            "postal_code": "133671229",
            "telephone_number": "315-376-5287",
            "fax_number": "315-376-3228"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7785 N STATE ST",
            "address_2": "SUITE 330",
            "city": "LOWVILLE",
            "state": "NY",
            "postal_code": "133671229",
            "telephone_number": "315-376-5287",
            "fax_number": "315-376-3228"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROOT",
        "first_name": "DANIEL",
        "middle_name": "TIMOTHY",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-10-21",
        "last_updated": "2013-01-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NY",
            "license": "1649401",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01178945",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Lowville, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 18, 2013; 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.