Individual provider Active NPI

Joel Orosa Paraiso, MD

  • Neurology Physician
  • Grand Island, NE
National Provider Identifier
1396863882
Registry record updated May 15, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neurology PhysicianTaxonomy code 2084N0400X
License
191123 Issued in NY
Practice address
403 Lexington Cir
Grand Island, NE 68803-9728
Phone
(402) 773-0115
Fax
(402) 773-0119
NPI assigned
Mar 26, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 15, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Neurology Physician 2084N0400X 191123 NY Primary

Addresses

Primary practice location

403 Lexington Cir
Grand Island, NE 68803-9728

Mailing address

8 Rose CT
Marlboro, NJ 07746-1980
Phone (732) 557-1699

Other identifiers 1

IdentifierTypeStateIssuer
01604920MedicaidNY

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
191123NYMDNeurology Physician

NPI Registry JSON

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

{
    "created_epoch": "1174867200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1589500800000",
    "number": "1396863882",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8 ROSE CT",
            "city": "MARLBORO",
            "state": "NJ",
            "postal_code": "077461980",
            "telephone_number": "732-557-1699"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "403 LEXINGTON CIR",
            "city": "GRAND ISLAND",
            "state": "NE",
            "postal_code": "688039728",
            "telephone_number": "402-773-0115",
            "fax_number": "402-773-0119"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PARAISO",
        "first_name": "JOEL",
        "middle_name": "OROSA",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-03-26",
        "last_updated": "2020-05-15",
        "certification_date": "2020-05-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084N0400X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "NY",
            "license": "191123",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01604920",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Grand Island, NE

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 15, 2020; 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.