Individual provider Active NPI

Richard Milhous Wood, MD

  • Surgery Physician
  • Kingston, NY
National Provider Identifier
1417997388
Registry record updated Feb 16, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
License
2210941 Issued in NY
Practice address
40 Hurley Ave
Suite 3
Kingston, NY 12401-3739
Phone
(845) 546-3403
Fax
(866) 844-7209
NPI assigned
Jun 7, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 16, 2015

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery Physician 208600000X 2210941 NY Primary
Surgery Physician 208600000X 041445 CT

Addresses

Primary practice location

40 Hurley Ave
Suite 3
Kingston, NY 12401-3739

Mailing address

33 Bingham Mills Rd
Germantown, NY 12526-5409
Phone (845) 546-3403

Other identifiers 1

IdentifierTypeStateIssuer
02188925MedicaidNY

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
041445CTMDSurgery Physician
2210941NYMDSurgery Physician

NPI Registry JSON

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

{
    "created_epoch": "1149638400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1424044800000",
    "number": "1417997388",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "33 BINGHAM MILLS RD",
            "city": "GERMANTOWN",
            "state": "NY",
            "postal_code": "125265409",
            "telephone_number": "845-546-3403",
            "fax_number": "866-844-7209"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "40 HURLEY AVE",
            "address_2": "SUITE 3",
            "city": "KINGSTON",
            "state": "NY",
            "postal_code": "124013739",
            "telephone_number": "845-546-3403",
            "fax_number": "866-844-7209"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WOOD",
        "first_name": "RICHARD",
        "middle_name": "MILHOUS",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-06-07",
        "last_updated": "2015-02-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "NY",
            "license": "2210941",
            "primary": true
        },
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "CT",
            "license": "041445",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02188925",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Kingston, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 16, 2015; 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.