Active NPI
Summit Medical PC
- Anesthesiology Physician
- Bayside, NY
National Provider Identifier
1487939856
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Anesthesiology Physician
- License
- 207025
- Legal business name
- SUMMIT MEDICAL PC
- Practice address
- 21333 39TH Ave
Suite 248
Bayside, NY 11361-2091 - Phone
- (718) 428-5333
- Fax
- (718) 428-5332
- NPI assigned
- Oct 18, 2011
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Dr. Won Sohn, M.D.
- Title
- Owner
- Phone
- (718) 428-5333
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) | Code | License | State | Primary |
|---|---|---|---|---|
| Anesthesiology Physician | 207L00000X | 207025 | NY | Primary |
Addresses
Primary practice location
21333 39TH Ave
Suite 248
Bayside, NY 11361-2091
Mailing address
PO Box 270
Massapequa Park, NY 11762-0270
Phone (631) 264-2035
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 02088860 | Medicaid | NY |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in NY
Enrollment records 1
National Provider Directory
National Provider DirectoryPractitioners & affiliated clinicians
Practitioners 7
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.
-
- Anatomic Pathology & Clinical Pathology Physician
- Manhasset, NY
- NPI 1154591378
-
- Anesthesiology Physician
- Brooklyn, NY
- NPI 1265521892
-
- Anesthesiology Physician
- Indianapolis, IN
- NPI 1396162467
NY, Single Specialty
-
- Anesthesiology Physician
- Jamaica, NY
- NPI 1053418764
-
- Gastroenterology Physician
- Bayside, NY
- NPI 1689626103
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1318896000000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1324252800000",
"number": "1487939856",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 270",
"city": "MASSAPEQUA PARK",
"state": "NY",
"postal_code": "117620270",
"telephone_number": "631-264-2035",
"fax_number": "631-264-1418"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "21333 39TH AVE",
"address_2": "SUITE 248",
"city": "BAYSIDE",
"state": "NY",
"postal_code": "113612091",
"telephone_number": "718-428-5333",
"fax_number": "718-428-5332"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "SUMMIT MEDICAL PC",
"organizational_subpart": "NO",
"enumeration_date": "2011-10-18",
"last_updated": "2011-12-19",
"status": "A",
"authorized_official_last_name": "SOHN",
"authorized_official_first_name": "WON",
"authorized_official_title_or_position": "OWNER",
"authorized_official_telephone_number": "718-428-5333",
"authorized_official_name_prefix": "Dr.",
"authorized_official_credential": "M.D."
},
"taxonomies": [
{
"code": "207L00000X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Anesthesiology",
"state": "NY",
"license": "207025",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "02088860",
"state": "NY"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Bayside, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 19, 2011; 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.