Organization Active NPI

Finger Lakes Orthopedic Surgery,P.C.

  • Legal Medicine
  • Elmira, NY
National Provider Identifier
1699712505
Registry record updated Mar 24, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Legal MedicineTaxonomy code 173000000X
License
145863 Issued in NY
Legal business name
FINGER LAKES ORTHOPEDIC SURGERY,P.C.
Practice address
300 Hoffman St
Elmira, NY 14905-2263
Phone
(607) 734-4110
Fax
(607) 734-0344
NPI assigned
May 31, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 24, 2008

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

Authorized official

Name
Dr. Mark D Gibson, M.D.NPI 1396757753
Title
President
Phone
(607) 734-4110

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Legal MedicineGroup: 193400000X SINGLE SPECIALTY GROUP 173000000X 145863 NY Primary

Addresses

Primary practice location

300 Hoffman St
Elmira, NY 14905-2263

Mailing address

300 Hoffman St
Elmira, NY 14905-2263
Phone (607) 734-4110

Other identifiers 1

IdentifierTypeStateIssuer
01287576MedicaidNY

National Provider Directory

National Provider Directory

Locations

200 Madison Ave
Ste A
Elmira, NY 14901
Phone (607) 733-3097

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1149033600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1206316800000",
    "number": "1699712505",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "300 HOFFMAN ST",
            "city": "ELMIRA",
            "state": "NY",
            "postal_code": "149052263",
            "telephone_number": "607-734-4110",
            "fax_number": "607-734-0344"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "300 HOFFMAN ST",
            "city": "ELMIRA",
            "state": "NY",
            "postal_code": "149052263",
            "telephone_number": "607-734-4110",
            "fax_number": "607-734-0344"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FINGER LAKES ORTHOPEDIC SURGERY,P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-31",
        "last_updated": "2008-03-24",
        "status": "A",
        "authorized_official_last_name": "GIBSON",
        "authorized_official_first_name": "MARK",
        "authorized_official_middle_name": "D",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "607-734-4110",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "173000000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Legal Medicine",
            "state": "NY",
            "license": "145863",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01287576",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Elmira, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 24, 2008; 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.