NPIMap

Organization Active NPI

Dysautonomia Center LLP

  • Pediatrics Physician
  • New York, NY
National Provider Identifier
1568699585
Registry record updated Jun 17, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
099123 Issued in NY
Legal business name
DYSAUTONOMIA CENTER LLP
Practice address
530 1St Ave
Suite 9Q
New York, NY 10016-6402
Phone
(212) 263-7225
Fax
(212) 263-7041
NPI assigned
Jun 17, 2009
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 17, 2009

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

Authorized official

Name
Dr. Felicia AxelrodNPI 1528143245
Title
Partner
Phone
(212) 263-7225

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 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 208000000X 099123 NY Primary
Neurology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 2084N0400X 168166 NY

Addresses

Primary practice location

530 1St Ave
Suite 9Q
New York, NY 10016-6402

Mailing address

530 1St Ave
Suite 9Q
New York, NY 10016-6402
Phone (212) 263-7225

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20090722000236 NY Part B Supplier - Clinic/Group Practice 4880745843 Receives reassigned benefits from 3 practitioners
Practice locations: New York, NY

National Provider Directory

National Provider Directory

Locations

530 1st Ave
#9Q
New York, NY 10016
Phone (212) 263-7225

Practitioners & affiliated clinicians

Practitioners 8

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": "1245196800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1245196800000",
    "number": "1568699585",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "530 1ST AVE",
            "address_2": "SUITE 9Q",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100166402",
            "telephone_number": "212-263-7225",
            "fax_number": "212-263-7041"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "530 1ST AVE",
            "address_2": "SUITE 9Q",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100166402",
            "telephone_number": "212-263-7225",
            "fax_number": "212-263-7041"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DYSAUTONOMIA CENTER LLP",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-06-17",
        "last_updated": "2009-06-17",
        "status": "A",
        "authorized_official_last_name": "AXELROD",
        "authorized_official_first_name": "FELICIA",
        "authorized_official_title_or_position": "PARTNER",
        "authorized_official_telephone_number": "212-263-7225",
        "authorized_official_name_prefix": "Dr."
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Pediatrics",
            "state": "NY",
            "license": "099123",
            "primary": true
        },
        {
            "code": "2084N0400X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "NY",
            "license": "168166",
            "primary": false
        }
    ],
    "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 Jun 17, 2009; 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.