Organization Active NPI

OB-GYN Associates of Ithaca, LLP

  • Obstetrics & Gynecology Physician
  • Ithaca, NY
National Provider Identifier
1437229945
Registry record updated Oct 11, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X
Legal business name
OB-GYN ASSOCIATES OF ITHACA, LLP
Practice address
20 Arrowood Dr
Ithaca, NY 14850-1857
Phone
(607) 266-7800
Fax
(607) 266-7811
NPI assigned
Nov 9, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 11, 2007

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

Authorized official

Name
Kathy M Bowers, M
Title
Manager
Phone
(607) 266-7800

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics & Gynecology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207V00000X Primary

Addresses

Primary practice location

20 Arrowood Dr
Ithaca, NY 14850-1857

Mailing address

20 Arrowood Dr
Ithaca, NY 14850-1857
Phone (607) 266-7800

Other identifiers 1

IdentifierTypeStateIssuer
02079147MedicaidNY

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040901000086 NY Part B Supplier - Clinic/Group Practice 5092780213 Receives reassigned benefits from 1 practitioner
Practice locations: Ithaca, NY

National Provider Directory

National Provider Directory

Locations

20 Arrowood Dr
Ste A
Ithaca, NY 14850
Phone (607) 266-7800

20 Arrowood Dr
Ithaca, NY 14850
Phone (607) 266-7800

Practitioners & affiliated clinicians

Practitioners 9

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1163030400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1192060800000",
    "number": "1437229945",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "20 ARROWOOD DR",
            "city": "ITHACA",
            "state": "NY",
            "postal_code": "148501857",
            "telephone_number": "607-266-7800",
            "fax_number": "607-266-7811"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "20 ARROWOOD DR",
            "city": "ITHACA",
            "state": "NY",
            "postal_code": "148501857",
            "telephone_number": "607-266-7800",
            "fax_number": "607-266-7811"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "OB-GYN ASSOCIATES OF ITHACA, LLP",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-09",
        "last_updated": "2007-10-11",
        "status": "A",
        "authorized_official_last_name": "BOWERS",
        "authorized_official_first_name": "KATHY",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "607-266-7800",
        "authorized_official_credential": "M"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Obstetrics & Gynecology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02079147",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Ithaca, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 11, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.