Organization Active NPI

Metropolitan Lithotriptor Associates, PC

  • Urology Physician
  • Fresh Meadows, NY
National Provider Identifier
1598794430
Registry record updated Dec 14, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Urology PhysicianTaxonomy code 208800000X
Legal business name
METROPOLITAN LITHOTRIPTOR ASSOCIATES, PC
Practice address
176-60 Union Turnpike
Suite 200
Fresh Meadows, NY 11366
Phone
(646) 742-8800
Fax
(646) 742-8850
NPI assigned
Jul 2, 2006
Last updated
Dec 14, 2018By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 14, 2018

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

Authorized official

Name
Mr. Joseph Pavlica
Title
Executive VP
Phone
(646) 742-8802

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Urology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 208800000X Primary

Addresses

Primary practice location

176-60 Union Turnpike
Suite 200
Fresh Meadows, NY 11366

Mailing address

205 Lexington Avenue
Floor 15
New York, NY 10016
Phone (646) 742-8800

Other identifiers 9

IdentifierTypeStateIssuer
ANC144OtherOXFORD
IC7854OtherHEALTHNET
293999OtherUNITED HEALTH CARE
346777374OtherVYTRA
97003OtherCIGNA
AZ00256MedicaidNY
1000332OtherGHI
8459536OtherAETNA
001151OtherHORIZON

National Provider Directory

National Provider Directory

Locations

17660 Union Tpke
Ste 200
Fresh Meadows, NY 11366
Phone (646) 742-8800

160 E 32nd St
Ste 101
New York, NY 10016
Phone (212) 481-8118

NPI Registry JSON

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

{
    "created_epoch": "1151798400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1544745600000",
    "number": "1598794430",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "205 LEXINGTON AVENUE",
            "address_2": "FLOOR 15",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "10016",
            "telephone_number": "646-742-8800",
            "fax_number": "646-742-8850"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "176-60 UNION TURNPIKE",
            "address_2": "SUITE 200",
            "city": "FRESH MEADOWS",
            "state": "NY",
            "postal_code": "11366",
            "telephone_number": "646-742-8800",
            "fax_number": "646-742-8850"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "METROPOLITAN LITHOTRIPTOR ASSOCIATES, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-02",
        "last_updated": "2018-12-14",
        "status": "A",
        "authorized_official_last_name": "PAVLICA",
        "authorized_official_first_name": "JOSEPH",
        "authorized_official_title_or_position": "EXECUTIVE VP",
        "authorized_official_telephone_number": "646-742-8802",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "208800000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Urology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OXFORD",
            "identifier": "ANC144",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTHNET",
            "identifier": "IC7854",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITED HEALTH CARE",
            "identifier": "293999",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "VYTRA",
            "identifier": "346777374",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CIGNA",
            "identifier": "97003",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "AZ00256",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GHI",
            "identifier": "1000332",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "8459536",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HORIZON",
            "identifier": "001151",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Fresh Meadows, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 14, 2018; 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.