Organization Active NPI

Manhattan Plastic Surgery Nyc, PLLC

  • Plastic Surgery Physician
  • New York, NY
National Provider Identifier
1386485514
Registry record updated Jun 3, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Plastic Surgery PhysicianTaxonomy code 208200000X
Legal business name
MANHATTAN PLASTIC SURGERY NYC, PLLC
Practice address
568 Park Avenue
New York, NY 10065-7370
Phone
(352) 325-5555
Fax
(346) 202-0106
NPI assigned
Jun 3, 2024
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 3, 2024

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

Authorized official

Name
Jack Caudill
Title
Practice Manager
Phone
(352) 325-5555

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Plastic Surgery PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 208200000X Primary

Addresses

Primary practice location

568 Park Avenue
New York, NY 10065-7370

Mailing address

568 Park Avenue
New York, NY 10065-7370
Phone (352) 325-5555

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1717372800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1717372800000",
    "number": "1386485514",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "568 PARK AVENUE",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100657370",
            "telephone_number": "352-325-5555",
            "fax_number": "346-202-0106"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "568 PARK AVENUE",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100657370",
            "telephone_number": "352-325-5555",
            "fax_number": "346-202-0106"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MANHATTAN PLASTIC SURGERY NYC, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-06-03",
        "last_updated": "2024-06-03",
        "certification_date": "2024-05-29",
        "status": "A",
        "authorized_official_last_name": "CAUDILL",
        "authorized_official_first_name": "JACK",
        "authorized_official_title_or_position": "PRACTICE MANAGER",
        "authorized_official_telephone_number": "352-325-5555"
    },
    "taxonomies": [
        {
            "code": "208200000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Plastic Surgery",
            "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 Jun 3, 2024; 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.