NPIMap

Organization Active NPI

Medical Health 360 PLLC

  • Pediatrics Physician
  • Dexter, NY
National Provider Identifier
1497374359
Registry record updated Apr 10, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
Legal business name
MEDICAL HEALTH 360 PLLC
Practice address
16955 County Route 59
Dexter, NY 13634-2027
Phone
(888) 860-0507
NPI assigned
Apr 10, 2020
Last updated
Apr 10, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 10, 2020

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

Authorized official

Name
Dr. Tattvamasi Parikh, MDNPI 1750726329
Title
Owner
Phone
(516) 724-7339

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)CodeLicenseStatePrimary
Pediatrics Physician 208000000X NU Primary

Addresses

Primary practice location

16955 County Route 59
Dexter, NY 13634-2027

Mailing address

117 Greenway W
New Hyde Park, NY 11040-2226
Phone (888) 860-0507

Other identifiers 1

IdentifierTypeStateIssuer
14442662MedicaidNY

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20210120002985 NY Part B Supplier - Clinic/Group Practice 7315351046 Receives reassigned benefits from 11 practitioners
Practice locations: Alexandria Bay, NY; Carthage, NY; Glens Falls, NY; Lowville, NY; Ogdensburg, NY; Oswego, NY; Watertown, NY

National Provider Directory

National Provider Directory

Locations

110 W 6th St
Oswego, NY 13126
Phone (315) 349-5511

Practitioners & affiliated clinicians

Practitioners 12

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1586476800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1586476800000",
    "number": "1497374359",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "117 GREENWAY W",
            "city": "NEW HYDE PARK",
            "state": "NY",
            "postal_code": "110402226",
            "telephone_number": "888-860-0507"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16955 COUNTY ROUTE 59",
            "city": "DEXTER",
            "state": "NY",
            "postal_code": "136342027",
            "telephone_number": "888-860-0507"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MEDICAL HEALTH 360 PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-04-10",
        "last_updated": "2020-04-10",
        "certification_date": "2020-04-10",
        "status": "A",
        "authorized_official_last_name": "PARIKH",
        "authorized_official_first_name": "TATTVAMASI",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "516-724-7339",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "14442662",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Dexter, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 10, 2020; 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.