NPIMap

Organization Active NPI

St Kilda Medical Service,PLLC

  • Specialist
  • New York, NY
National Provider Identifier
1528378668
Registry record updated Jul 21, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
156442 Issued in NY
Legal business name
ST KILDA MEDICAL SERVICE,PLLC
Practice address
1067 5TH Ave
New York, NY 10128-0101
Phone
(212) 874-3384
Fax
(212) 874-0031
NPI assigned
Oct 7, 2010
Last updated
Jul 21, 2011By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2011

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

Authorized official

Name
Blair S Lewis, MDNPI 1689765521
Title
Owner
Phone
(212) 874-3384

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X 156442 NY Primary

Addresses

Primary practice location

1067 5TH Ave
New York, NY 10128-0101

Mailing address

1067 5TH Ave
New York, NY 10128-0101
Phone (212) 874-3384

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 24

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.

View all 24

NPI Registry JSON

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

{
    "created_epoch": "1286409600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1311206400000",
    "number": "1528378668",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1067 5TH AVE",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "101280101",
            "telephone_number": "212-874-3384",
            "fax_number": "212-874-0031"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1067 5TH AVE",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "101280101",
            "telephone_number": "212-874-3384",
            "fax_number": "212-874-0031"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ST KILDA MEDICAL SERVICE,PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-10-07",
        "last_updated": "2011-07-21",
        "status": "A",
        "authorized_official_last_name": "LEWIS",
        "authorized_official_first_name": "BLAIR",
        "authorized_official_middle_name": "S",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "212-874-3384",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "NY",
            "license": "156442",
            "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 Jul 21, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.