NPIMap

Organization Active NPI

York Anesthesiologists PLLC

  • Anesthesiology Physician
  • New York, NY
National Provider Identifier
1508947441
Registry record updated Dec 20, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
Legal business name
YORK ANESTHESIOLOGISTS PLLC
Practice address
1St Avenue at 16TH St
Beth Israel Medical Center/Petrie Division
New York, NY 10003
Phone
(212) 420-2385
NPI assigned
Oct 18, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 20, 2012

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

Authorized official

Name
Sundararao Koppolu, M.D.
Title
Chief of Anesthesia
Phone
(212) 420-2385

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207L00000X Primary

Addresses

Primary practice location

1St Avenue at 16TH St
Beth Israel Medical Center/Petrie Division
New York, NY 10003

Mailing address

PO Box 270
Massapequa Park, NY 11762-0270
Phone (631) 264-2035

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040322001734 NY Part B Supplier - Clinic/Group Practice 3072404805 Receives reassigned benefits from 94 practitioners
Practice locations: New York, NY; Bronx, NY; Brooklyn, NY; Cortlandt Manor, NY

National Provider Directory

National Provider Directory

Locations

1978 Crompond Rd
Ste 105
Cortlandt Mnr, NY 10567
Phone (914) 603-5072

325 W 15th St
Side
New York, NY 10011

Practitioners & affiliated clinicians

Practitioners 95

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

View all 95

NPI Registry JSON

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

{
    "created_epoch": "1161129600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1355961600000",
    "number": "1508947441",
    "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": "1ST AVENUE AT 16TH ST",
            "address_2": "BETH ISRAEL MEDICAL CENTER/PETRIE DIVISION",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "10003",
            "telephone_number": "212-420-2385"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "YORK ANESTHESIOLOGISTS PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-18",
        "last_updated": "2012-12-20",
        "status": "A",
        "authorized_official_last_name": "KOPPOLU",
        "authorized_official_first_name": "SUNDARARAO",
        "authorized_official_title_or_position": "CHIEF OF ANESTHESIA",
        "authorized_official_telephone_number": "212-420-2385",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Anesthesiology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "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 Dec 20, 2012; 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.