NPIMap

Organization Active NPI

Sovereign Medical Services PC

  • Vascular Surgery Physician
  • Jericho, NY
National Provider Identifier
1629380449
Registry record updated Jul 9, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Vascular Surgery PhysicianTaxonomy code 2086S0129X
License
176016 Issued in NY
Legal business name
SOVEREIGN MEDICAL SERVICES PC
Practice address
420 Jericho Tpke
Suite 212
Jericho, NY 11753-1344
Phone
(516) 277-2121
Fax
(516) 277-2122
NPI assigned
Jul 9, 2010
Last updated
Jul 9, 2010By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 9, 2010

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

Authorized official

Name
Dr. Jonathan Landow, MDNPI 1508139007
Title
President
Phone
(516) 277-2121

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Vascular Surgery Physician 2086S0129X 176016 NY Primary

Addresses

Primary practice location

420 Jericho Tpke
Suite 212
Jericho, NY 11753-1344

Mailing address

420 Jericho Tpke
Suite 212
Jericho, NY 11753-1344
Phone (516) 277-2121

National Provider Directory

National Provider Directory
Tax ID family
Sovereign Medical Services PC2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Locations

420 Jericho Tpke
Ste 212
Jericho, NY 11753
Phone (516) 277-2121

Practitioners & affiliated clinicians

Practitioners 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1278633600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1278633600000",
    "number": "1629380449",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "420 JERICHO TPKE",
            "address_2": "SUITE 212",
            "city": "JERICHO",
            "state": "NY",
            "postal_code": "117531344",
            "telephone_number": "516-277-2121",
            "fax_number": "516-277-2122"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "420 JERICHO TPKE",
            "address_2": "SUITE 212",
            "city": "JERICHO",
            "state": "NY",
            "postal_code": "117531344",
            "telephone_number": "516-277-2121",
            "fax_number": "516-277-2122"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOVEREIGN MEDICAL SERVICES PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-07-09",
        "last_updated": "2010-07-09",
        "status": "A",
        "authorized_official_last_name": "LANDOW",
        "authorized_official_first_name": "JONATHAN",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "516-277-2121",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "2086S0129X",
            "taxonomy_group": "",
            "desc": "Surgery, Vascular Surgery",
            "state": "NY",
            "license": "176016",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jericho, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2010; 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.