Active NPI
David P Wood, PA-C
- Physician Assistant
- New York, NY
National Provider Identifier
1487752317
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- License
- 00000922
- Practice address
- 8 E 3Rd St
New York, NY 10003-8908 - Phone
- (917) 968-6047
- NPI assigned
- Sep 21, 2006
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | 00000922 | NY | Primary |
Addresses
Primary practice location
8 E 3Rd St
New York, NY 10003-8908
Mailing address
304 Denton Ave
Lynbrook, NY 11563-2112
Phone (516) 593-3833
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 00000922 | Medicaid | NY |
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
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 000922 | NY | MD | Psychoanalysis Psychologist |
| 00000922 | NY | MD | Physician Assistant |
Networks
- Healthfirst Medicare Network H3359
- Healthfirst Medicare Network H5989
- Healthfirst Medicare Network H9678
- Healthfirst Medicare Network H1722
Interoperability endpoints
- david.wood@pri1.eclinicaldirectplus.com
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1158796800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1487752317",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "304 DENTON AVE",
"city": "LYNBROOK",
"state": "NY",
"postal_code": "115632112",
"telephone_number": "516-593-3833"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "8 E 3RD ST",
"city": "NEW YORK",
"state": "NY",
"postal_code": "100038908",
"telephone_number": "917-968-6047"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WOOD",
"first_name": "DAVID",
"middle_name": "P",
"credential": "PA-C",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-09-21",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "NY",
"license": "00000922",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "00000922",
"state": "NY"
}
],
"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 Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.