NPIMap

Organization Active NPI

Premise Health of New York Medical, P.C

  • Corporate Health Clinic/Center
  • New York, NY
National Provider Identifier
1407177272
Registry record updated Aug 15, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Corporate Health Clinic/CenterTaxonomy code 261QC1800X
License
008673 Issued in NY
Legal business name
PREMISE HEALTH OF NEW YORK MEDICAL, P.C
Practice address
1585 Broadway
8TH Floor
New York, NY 10036-8200
Phone
(212) 761-7989
NPI assigned
Jun 16, 2010
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 15, 2022

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

Authorized official

Name
Dr. Jon Leizman, PA-C
Title
President
Phone
(216) 479-9063

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Corporate Health Clinic/Center 261QC1800X 008673 NY Primary

Addresses

Primary practice location

1585 Broadway
8TH Floor
New York, NY 10036-8200

Mailing address

1585 Broadway
8TH Floor
New York, NY 10036-8200
Phone (212) 761-7989

National Provider Directory

National Provider Directory
Tax ID family
Premise Health of New York Medical PC37 organizations share this tax ID, including this one

Other organizations with this tax ID 36

Organizations that report the same tax identification number in the National Provider Directory.

View all 36

Locations

1585 Broadway
Fl 8
New York, NY 10036
Phone (212) 761-6300

NPI Registry JSON

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

{
    "created_epoch": "1276646400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1660521600000",
    "number": "1407177272",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1585 BROADWAY",
            "address_2": "8TH FLOOR",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100368200",
            "telephone_number": "212-761-7989"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1585 BROADWAY",
            "address_2": "8TH FLOOR",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100368200",
            "telephone_number": "212-761-7989"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PREMISE HEALTH OF NEW YORK MEDICAL, P.C",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-06-16",
        "last_updated": "2022-08-15",
        "certification_date": "2022-08-15",
        "status": "A",
        "authorized_official_last_name": "LEIZMAN",
        "authorized_official_first_name": "JON",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "216-479-9063",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PA-C"
    },
    "taxonomies": [
        {
            "code": "261QC1800X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Corporate Health",
            "state": "NY",
            "license": "008673",
            "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 Aug 15, 2022; 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.