NPIMap

Organization Active NPI

Hurley Avenue Family Medicine

  • Family Medicine Physician
  • Stone Ridge, NY
National Provider Identifier
1669964706
Registry record updated Jun 5, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
HURLEY AVENUE FAMILY MEDICINE
Practice address
10 Gagnon Dr.
Stone Ridge, NY 12484
Phone
(845) 687-7455
Fax
(845) 687-4685
NPI assigned
Jun 5, 2018
Last updated
Jun 5, 2018By the provider in NPPES
Organization subpart
Yes
Parent organization
HURLEY AVENUE FAMILY MEDICINEAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Jun 5, 2018

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

Authorized official

Name
Matthias Vonreusner, MDNPI 1437140233
Title
MD/Partner
Phone
(845) 338-2541

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
Family Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207Q00000X Primary

Addresses

Primary practice location

10 Gagnon Dr.
Stone Ridge, NY 12484

Mailing address

10 Gagnon Dr.
Stone Ridge, NY 12484
Phone (845) 687-7455

Other names 1

  • Stone Ridge Family Practice Other name

National Provider Directory

National Provider Directory
Tax ID family
Hurley Avenue Family Me4 organizations share this tax ID, including this one
Part of
Hurley Avenue Family Me

Other organizations with this tax ID 3

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

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": "1528156800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1528156800000",
    "number": "1669964706",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10 GAGNON DR.",
            "city": "STONE RIDGE",
            "state": "NY",
            "postal_code": "12484",
            "telephone_number": "845-687-7455",
            "fax_number": "845-687-4685"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10 GAGNON DR.",
            "city": "STONE RIDGE",
            "state": "NY",
            "postal_code": "12484",
            "telephone_number": "845-687-7455",
            "fax_number": "845-687-4685"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HURLEY AVENUE FAMILY MEDICINE",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "HURLEY AVENUE FAMILY MEDICINE",
        "enumeration_date": "2018-06-05",
        "last_updated": "2018-06-05",
        "status": "A",
        "authorized_official_last_name": "VONREUSNER",
        "authorized_official_first_name": "MATTHIAS",
        "authorized_official_title_or_position": "MD/PARTNER",
        "authorized_official_telephone_number": "845-338-2541",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Stone Ridge Family Practice",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Stone Ridge, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 5, 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.