Organization Active NPI

New York City Osteopathy, PLLC

  • Family Medicine Physician
  • New York, NY
National Provider Identifier
1376864348
Registry record updated Feb 19, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
NEW YORK CITY OSTEOPATHY, PLLC
Practice address
40 Exchange PL Ste 1704
New York, NY 10005-2780
Phone
(212) 344-5361
Fax
(212) 514-5460
NPI assigned
Jun 14, 2010
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 19, 2019

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

Authorized official

Name
Dr. Brian J WaldronNPI 1093785651
Title
Owner
Phone
(212) 344-5361

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 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207Q00000X Primary

Addresses

Primary practice location

40 Exchange PL Ste 1704
New York, NY 10005-2780

Mailing address

40 Exchange PL Ste 1704
New York, NY 10005-2780
Phone (212) 344-5361

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20100915000667 NY Part B Supplier - Clinic/Group Practice 8224153184 Receives reassigned benefits from 2 practitioners
Practice locations: New York, NY

National Provider Directory

National Provider Directory

Locations

40 Exchange Pl
Ste 1704
New York, NY 10005
Phone (212) 344-5361

Practitioners & affiliated clinicians

Practitioners 2

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": "1276473600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1550534400000",
    "number": "1376864348",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "40 EXCHANGE PL STE 1704",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100052780",
            "telephone_number": "212-344-5361",
            "fax_number": "212-514-5460"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "40 EXCHANGE PL STE 1704",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100052780",
            "telephone_number": "212-344-5361",
            "fax_number": "212-514-5460"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NEW YORK CITY OSTEOPATHY, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-06-14",
        "last_updated": "2019-02-19",
        "status": "A",
        "authorized_official_last_name": "WALDRON",
        "authorized_official_first_name": "BRIAN",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "212-344-5361",
        "authorized_official_name_prefix": "Dr."
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "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 Feb 19, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.