NPIMap

Organization Active NPI

New York Anesthesiology Medical Specialties, PC

Doing business as New York Spine & Wellness Center

  • Durable Medical Equipment & Medical Supplies
  • Depew, NY
National Provider Identifier
1487029815
Registry record updated Jan 7, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X
Legal business name
NEW YORK ANESTHESIOLOGY MEDICAL SPECIALTIES, PC
Doing business as
New York Spine & Wellness Center
New York Spine and Wellness Center
Practice address
6430 Transit Rd Ste 300
Depew, NY 14043-1033
Phone
(315) 552-6700
NPI assigned
Dec 10, 2015
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 7, 2021

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

Authorized official

Name
Robert L Tiso
Title
MD
Phone
(315) 251-3105

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pain Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 208VP0000X
Durable Medical Equipment & Medical Supplies 332B00000X Primary

Addresses

Primary practice location

6430 Transit Rd Ste 300
Depew, NY 14043-1033

Mailing address

PO Box 510
Syracuse, NY 13214-0510
Phone (315) 251-3105

Other identifiers 1

IdentifierTypeStateIssuer
03423585MedicaidNY

Other names 2

  • New York Spine & Wellness Center Doing business as
  • New York Spine and Wellness Center Doing business as

National Provider Directory

National Provider Directory
Tax ID family
New York Anesthesiology Medical Specialties PC4 organizations share this tax ID, including this one

Other organizations with this tax ID 3

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

Locations

6430 Transit Rd
Ste 300
Depew, NY 14043
Phone (315) 552-6700

NPI Registry JSON

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

{
    "created_epoch": "1449705600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1609977600000",
    "number": "1487029815",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 510",
            "city": "SYRACUSE",
            "state": "NY",
            "postal_code": "132140510",
            "telephone_number": "315-251-3105"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6430 TRANSIT RD STE 300",
            "city": "DEPEW",
            "state": "NY",
            "postal_code": "140431033",
            "telephone_number": "315-552-6700"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NEW YORK ANESTHESIOLOGY MEDICAL SPECIALTIES, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-12-10",
        "last_updated": "2021-01-07",
        "certification_date": "2021-01-07",
        "status": "A",
        "authorized_official_last_name": "TISO",
        "authorized_official_first_name": "ROBERT",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "MD",
        "authorized_official_telephone_number": "315-251-3105"
    },
    "taxonomies": [
        {
            "code": "208VP0000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Pain Medicine, Pain Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "03423585",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "New York Spine & Wellness Center",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "New York Spine and Wellness Center",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "New York Spine and Wellness Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Depew, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 7, 2021; 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.