Organization Active NPI

Cortland ENT, PC

  • Sleep Medicine (Otolaryngology) Physician
  • Cortland, NY
National Provider Identifier
1417144239
Registry record updated Apr 28, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Sleep Medicine (Otolaryngology) PhysicianTaxonomy code 207YS0012X
License
241226 Issued in NY
Legal business name
CORTLAND ENT, PC
Practice address
64 Pomeroy St
Cortland, NY 13045-2708
Phone
(607) 753-6560
Fax
(607) 753-6566
NPI assigned
Sep 25, 2007
Last updated
Apr 28, 2011By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 28, 2011

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

Authorized official

Name
Manoj Kumar, MDNPI 1013922335
Title
Owner
Phone
(607) 753-6560

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
Sleep Medicine (Otolaryngology) PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207YS0012X 241226 NY Primary

Addresses

Primary practice location

64 Pomeroy St
Cortland, NY 13045-2708

Mailing address

64 Pomeroy St
Cortland, NY 13045-2708
Phone (607) 753-6560

Other identifiers 1

IdentifierTypeStateIssuer
02806619MedicaidNY

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20071203000071 NY Part B Supplier - Clinic/Group Practice 5698864429 Receives reassigned benefits from 16 practitioners
Practice locations: Cortland, NY

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
33D1081567Cortland ENT PC64 Pomeroy Street, Cortland, NY 13045ComplianceJul 31, 2026

National Provider Directory

National Provider Directory

Locations

1104 Commons Ave
Cortland, NY 13045
Phone (607) 758-3750

230 S Fulton St
Ithaca, NY 14850
Phone (607) 379-6039

Practitioners & affiliated clinicians

Practitioners 16

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.

View all 16

NPI Registry JSON

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

{
    "created_epoch": "1190678400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1303948800000",
    "number": "1417144239",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "64 POMEROY ST",
            "city": "CORTLAND",
            "state": "NY",
            "postal_code": "130452708",
            "telephone_number": "607-753-6560",
            "fax_number": "607-753-6566"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "64 POMEROY ST",
            "city": "CORTLAND",
            "state": "NY",
            "postal_code": "130452708",
            "telephone_number": "607-753-6560",
            "fax_number": "607-753-6566"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CORTLAND ENT, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-09-25",
        "last_updated": "2011-04-28",
        "status": "A",
        "authorized_official_last_name": "KUMAR",
        "authorized_official_first_name": "MANOJ",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "607-753-6560",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207YS0012X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Otolaryngology, Sleep Medicine",
            "state": "NY",
            "license": "241226",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02806619",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Cortland, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 28, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.