Urantia Medical PC

Primary specialty

SpecialistTaxonomy code 174400000X

License

1818101 Issued in NY

Legal business name

URANTIA MEDICAL PC

Practice address

1295 Northern Blvd
Suite 20
Manhasset, NY 11030-3035

Phone

(516) 365-4040

NPI assigned

Mar 2, 2012

Organization subpart

No

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

Authorized official

Name

Modesto Fontanez, M.D.

Title

Principal

Phone

(516) 365-4040

Specialties & licenses 2

Addresses

Other identifiers 1

Locations

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

{
    "created_epoch": "1330646400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1332460800000",
    "number": "1679847008",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1295 NORTHERN BLVD",
            "city": "MANHASSET",
            "state": "NY",
            "postal_code": "110303035",
            "telephone_number": "516-365-4040"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1295 NORTHERN BLVD",
            "address_2": "SUITE 20",
            "city": "MANHASSET",
            "state": "NY",
            "postal_code": "110303035",
            "telephone_number": "516-365-4040"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "URANTIA MEDICAL PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-03-02",
        "last_updated": "2012-03-23",
        "status": "A",
        "authorized_official_last_name": "FONTANEZ",
        "authorized_official_first_name": "MODESTO",
        "authorized_official_title_or_position": "PRINCIPAL",
        "authorized_official_telephone_number": "516-365-4040",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Specialist",
            "state": "NY",
            "license": "1818101",
            "primary": true
        },
        {
            "code": "174400000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Specialist",
            "state": "NY",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01583586",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Josephine Tutrani, LCD
• Ni-Asia Twiggs
• Evelyn Twohig, NP
• Prashin Chetan Unadkat, M.B.B.S., PHD
• Philipp Underwood, MD
• Casey Urban
• Urology Associates PC
• Lauren Ursillo, M.D.
• US Rehabilitation Medicine Consulting, PLLC
• Sarah Ustoyev, MD

• Specialist in Manhasset, NY
• Providers in Manhasset, NY by specialty
• Specialist in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 23, 2012; 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.