NPIMap

Organization Active NPI

North Country Orthopaedic Group PC

  • Orthopaedic Surgery Physician
  • Watertown, NY
National Provider Identifier
1568445344
Registry record updated Nov 2, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthopaedic Surgery PhysicianTaxonomy code 207X00000X
Legal business name
NORTH COUNTRY ORTHOPAEDIC GROUP PC
Practice address
1571 Washington St
Suite 201
Watertown, NY 13601-9304
Phone
(315) 782-1650
Fax
(315) 788-8547
NPI assigned
Nov 25, 2005
Last updated
Nov 2, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 2, 2023

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

Authorized official

Name
Bruce L BairdNPI 1609859966
Title
Director/Officer
Phone
(315) 782-1650

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 10

Specialty (taxonomy)CodeLicenseStatePrimary
Endocrinology, Diabetes & Metabolism Physician 207RE0101X
Orthopaedic Surgery Physician 207X00000X Primary
Physical Medicine & Rehabilitation Physician 208100000X
Surgery Physician 208600000X
Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician 208G00000X
Physical Therapist 225100000X
Podiatric Clinic/Center 261QP1100X
Physician Assistant 363A00000X
Adult Health Nurse Practitioner 363LA2200X
Family Nurse Practitioner 363LF0000X

Addresses

Primary practice location

1571 Washington St
Suite 201
Watertown, NY 13601-9304

Mailing address

1571 Washington St
Suite 201
Watertown, NY 13601-9304
Phone (315) 782-1650

Other identifiers 2

IdentifierTypeStateIssuer
00574887MedicaidNY
0315680001OtherDMERC

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040419001437 NY Part B Supplier - Clinic/Group Practice 8426043381 Receives reassigned benefits from 30 practitioners
Practice locations: Watertown, NY

National Provider Directory

National Provider Directory

Locations

1001 West St
Carthage, NY 13619
Phone (315) 493-1000

1571 Washington St
Ste 103
Watertown, NY 13601
Phone (315) 464-6264

1571 Washington St
Ste 104
Watertown, NY 13601
Phone (315) 782-1650

1571 Washington St
Ste 106
Watertown, NY 13601
Phone (315) 782-4643

1571 Washington St
Ste 20
Watertown, NY 13601

Practitioners & affiliated clinicians

Practitioners 35

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 35

NPI Registry JSON

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

{
    "created_epoch": "1132876800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1698883200000",
    "number": "1568445344",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1571 WASHINGTON ST",
            "address_2": "SUITE 201",
            "city": "WATERTOWN",
            "state": "NY",
            "postal_code": "136019304",
            "telephone_number": "315-782-1650",
            "fax_number": "315-788-8547"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1571 WASHINGTON ST",
            "address_2": "SUITE 201",
            "city": "WATERTOWN",
            "state": "NY",
            "postal_code": "136019304",
            "telephone_number": "315-782-1650",
            "fax_number": "315-788-8547"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NORTH COUNTRY ORTHOPAEDIC GROUP PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-11-25",
        "last_updated": "2023-11-02",
        "certification_date": "2023-11-02",
        "status": "A",
        "authorized_official_last_name": "BAIRD",
        "authorized_official_first_name": "BRUCE",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "DIRECTOR/OFFICER",
        "authorized_official_telephone_number": "315-782-1650"
    },
    "taxonomies": [
        {
            "code": "207RE0101X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Endocrinology, Diabetes & Metabolism",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207X00000X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "208100000X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "208G00000X",
            "taxonomy_group": "",
            "desc": "Thoracic Surgery (Cardiothoracic Vascular Surgery)",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QP1100X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Podiatric",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00574887",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DMERC",
            "identifier": "0315680001",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Watertown, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 2, 2023; 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.