Premier Medical Associates of the Hudson Valley

Primary specialty

Surgery PhysicianTaxonomy code 208600000X

Legal business name

PREMIER MEDICAL ASSOCIATES OF THE HUDSON VALLEY

Practice address

11 Peekskill Hollow Rd
112
Putnam Valley, NY 10579-3200

Phone

(845) 526-2080

NPI assigned

Mar 2, 2015

Last updated

Oct 15, 2015By the provider in NPPES

Organization subpart

Yes

Parent organization

NORTHERN WESTCHESTER SURGICAL ASSOCIATES, LLPAs reported in NPPES

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

Authorized official

Name

Carlos Jativa

Title

Cfo

Phone

(845) 526-2080

Specialties & licenses 1

Addresses

Part of

Northern Westchester Surgical Associates LLP

Locations

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

• Northern Westchester Surgical Associates, LLP

  • Surgery Physician
  • Putnam Valley, NY
  • NPI 1043331317
  NPPES parent name

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

{
    "created_epoch": "1425254400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1444867200000",
    "number": "1558753491",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11 PEEKSKILL HOLLOW RD",
            "address_2": "112",
            "city": "PUTNAM VALLEY",
            "state": "NY",
            "postal_code": "105793200"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11 PEEKSKILL HOLLOW RD",
            "address_2": "112",
            "city": "PUTNAM VALLEY",
            "state": "NY",
            "postal_code": "105793200",
            "telephone_number": "845-526-2080"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PREMIER MEDICAL ASSOCIATES OF THE HUDSON VALLEY",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "NORTHERN WESTCHESTER SURGICAL ASSOCIATES, LLP",
        "enumeration_date": "2015-03-02",
        "last_updated": "2015-10-15",
        "status": "A",
        "authorized_official_last_name": "JATIVA",
        "authorized_official_first_name": "CARLOS",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "845-526-2080"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Richard Andrew Peri, RN
• Gregory Perlman, LCSW
• Pamela Petkanas, L.C.S.W.
• Rick Martin Pezzullo, DPT
• Susan Mary Powers-Kulusic, LCSW
• Putnam Valley Central School District
• Putnam Valley Pediatrics, P.C.
• Putnam Valley Pharmacy Inc
• Putnam Valley Volunteer Ambulance Corporations Inc
• Martha Tiresina Rabson, TEACHER

• Surgery Physician in Putnam Valley, NY
• Providers in Putnam Valley, NY by specialty
• Surgery Physician in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 15, 2015; 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.