Active NPI
Paul Kriegstein
- Driver
- Ithaca, NY
National Provider Identifier
1508211426
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Driver
- License
- 280075992
- Practice address
- 618 Elmira Rd
Ithaca, NY 14850-8745 - Phone
- (607) 588-8888
- Fax
- (607) 697-0489
- NPI assigned
- Apr 28, 2016
- Sex
- Male
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Driver | 172A00000X | 280075992 | NY | Primary |
Addresses
Primary practice location
618 Elmira Rd
Ithaca, NY 14850-8745
Mailing address
618 Elmira Rd
Ithaca, NY 14850-8745
Phone (607) 588-8888
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 03348318 | 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)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 280075992 | NY | MD | Driver |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Collegetown Cab Inc | Past | Accepting new patients |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1461801600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1461801600000",
"number": "1508211426",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "618 ELMIRA RD",
"city": "ITHACA",
"state": "NY",
"postal_code": "148508745",
"telephone_number": "607-588-8888",
"fax_number": "607-697-0489"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "618 ELMIRA RD",
"city": "ITHACA",
"state": "NY",
"postal_code": "148508745",
"telephone_number": "607-588-8888",
"fax_number": "607-697-0489"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KRIEGSTEIN",
"first_name": "PAUL",
"name_prefix": "Mr.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2016-04-28",
"last_updated": "2016-04-28",
"status": "A"
},
"taxonomies": [
{
"code": "172A00000X",
"taxonomy_group": "",
"desc": "Driver",
"state": "NY",
"license": "280075992",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "03348318",
"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 Apr 28, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.