CCN -Wny Ipa LLC

Primary specialty

Preferred Provider OrganizationTaxonomy code 305R00000X

Legal business name

CCN -WNY IPA LLC

Practice address

4 Greenwich Office Park
Floor 2
Greenwich, CT 06831-5153

Phone

(914) 251-0300

NPI assigned

Mar 11, 2016

Organization subpart

Yes

Parent organization

EVICOREAs reported in NPPES

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

Authorized official

Name

Mr. Richard W. Kaplan

Title

Senior Vice President

Phone

(914) 251-0300

Specialties & licenses 1

Addresses

Other names 1

• New York Health Care Providers IPA LLC Doing business as

Part of

CCN -Wny Ipa LLC

Locations

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

{
    "created_epoch": "1457654400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1457654400000",
    "number": "1669833158",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4 GREENWICH OFFICE PARK",
            "address_2": "FLOOR 2",
            "city": "GREENWICH",
            "state": "CT",
            "postal_code": "068315153",
            "telephone_number": "914-251-0300"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4 GREENWICH OFFICE PARK",
            "address_2": "FLOOR 2",
            "city": "GREENWICH",
            "state": "CT",
            "postal_code": "068315153",
            "telephone_number": "914-251-0300"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CCN -WNY IPA LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "EVICORE",
        "enumeration_date": "2016-03-11",
        "last_updated": "2016-03-11",
        "status": "A",
        "authorized_official_last_name": "KAPLAN",
        "authorized_official_first_name": "RICHARD",
        "authorized_official_middle_name": "W.",
        "authorized_official_title_or_position": "SENIOR VICE PRESIDENT",
        "authorized_official_telephone_number": "914-251-0300",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "305R00000X",
            "taxonomy_group": "",
            "desc": "Preferred Provider Organization",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "New York Health Care Providers IPA LLC",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Brenda Sambrano Cataylo, REGISTERED NURSE
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• Preferred Provider Organization in Greenwich, CT
• Providers in Greenwich, CT by specialty
• Preferred Provider Organization in Connecticut

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 11, 2016; 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.