Active NPI
Gregory Sealy
- Surgical Physician Assistant
- Bronx, NY
National Provider Identifier
1568505709
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Surgical Physician Assistant
- License
- 009117
- Practice address
- 1650 Grand Concourse
Bronx, NY 10457-7606 - Phone
- (646) 271-9170
- NPI assigned
- Feb 15, 2007
- Last updated
- Jul 8, 2007
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Surgical Physician Assistant | 363AS0400X | 009117 | NY | Primary |
Addresses
Primary practice location
1650 Grand Concourse
Bronx, NY 10457-7606
Mailing address
1636 Lawrence St
Rahway, NJ 07065-5145
Phone (646) 271-9170
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 009117 | NY | MD | Physical Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Dra Imaging, PC | Past | Accepting new patients |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
- Diagnostic Radiology Physician
- Poughkeepsie, NY
- NPI 1477525061
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1171497600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1568505709",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1636 LAWRENCE ST",
"city": "RAHWAY",
"state": "NJ",
"postal_code": "070655145",
"telephone_number": "646-271-9170"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1650 GRAND CONCOURSE",
"city": "BRONX",
"state": "NY",
"postal_code": "104577606",
"telephone_number": "646-271-9170"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SEALY",
"first_name": "GREGORY",
"name_prefix": "Mr.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2007-02-15",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "363AS0400X",
"taxonomy_group": "",
"desc": "Physician Assistant, Surgical",
"state": "NY",
"license": "009117",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Bronx, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.