Organization Active NPI

Intraoperative Neurology Services PC

  • Clinical Neurophysiology Physician
  • Latham, NY
National Provider Identifier
1548739006
Registry record updated May 20, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Neurophysiology PhysicianTaxonomy code 2084N0600X
Legal business name
INTRAOPERATIVE NEUROLOGY SERVICES PC
Practice address
5 Francis PL
Latham, NY 12110-1613
Phone
(518) 727-2238
NPI assigned
Nov 14, 2018
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 20, 2024

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

Authorized official

Name
Michael Riley, MS, CNIMNPI 1063903920
Title
Administrator
Phone
(518) 727-2238

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
Clinical Neurophysiology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 2084N0600X Primary

Addresses

Primary practice location

5 Francis PL
Latham, NY 12110-1613

Mailing address

5 Francis PL
Latham, NY 12110-1613
Phone (518) 727-2238

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20190131001018 NY Part B Supplier - Clinic/Group Practice 1850638768 Receives reassigned benefits from 1 practitioner
Practice locations: Melville, NY

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 3

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

NPI Registry JSON

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

{
    "created_epoch": "1542153600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1716163200000",
    "number": "1548739006",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5 FRANCIS PL",
            "city": "LATHAM",
            "state": "NY",
            "postal_code": "121101613",
            "telephone_number": "518-727-2238"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5 FRANCIS PL",
            "city": "LATHAM",
            "state": "NY",
            "postal_code": "121101613",
            "telephone_number": "518-727-2238"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "INTRAOPERATIVE NEUROLOGY SERVICES PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-11-14",
        "last_updated": "2024-05-20",
        "certification_date": "2024-05-20",
        "status": "A",
        "authorized_official_last_name": "RILEY",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "518-727-2238",
        "authorized_official_credential": "MS, CNIM"
    },
    "taxonomies": [
        {
            "code": "2084N0600X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychiatry & Neurology, Clinical Neurophysiology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Latham, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 20, 2024; 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.