Jason John Psillakis, DDS MS

Primary specialty

ProsthodonticsTaxonomy code 1223P0700X

License

046095 Issued in NY

Practice address

16 E 60TH St Ste 380
New York, NY 10022-1002

Phone

(212) 326-8520

NPI assigned

Mar 14, 2007

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in NY

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Science

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Columbia Dental Faculty Practice

  • Dentist
  • New York, NY
  • NPI 1417159104
  NPD (past)

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

{
    "created_epoch": "1173830400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1376677369",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 RELDYES AVE",
            "city": "LEONIA",
            "state": "NJ",
            "postal_code": "076051323",
            "telephone_number": "201-615-7185"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16 E 60TH ST STE 380",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100221002",
            "telephone_number": "212-326-8520"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PSILLAKIS",
        "first_name": "JASON",
        "middle_name": "JOHN",
        "name_prefix": "Dr.",
        "credential": "DDS MS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-03-14",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223P0700X",
            "taxonomy_group": "",
            "desc": "Dentist, Prosthodontics",
            "state": "NY",
            "license": "046095",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Grace Przybylska Conroy, PH.D. LCSW
• PS Plastic Surgery, PC
• Panagiotis George Psalidas, MD
• George Psaltis, DMD
• George Psevdos Jr., M.D.,
• Psoas Massage Therapy Offices, P.C.
• Corinna Eleni Psomadakis, MBBS
• Nicole Marie Psomas, MSPT
• John Jason Psonis
• Psych Matters PLLC

• Prosthodontics in New York, NY
• Providers in New York, NY by specialty
• Prosthodontics in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.