Individual provider Active NPI

Robert Shick, DMD

  • Dentist
  • New York, NY
National Provider Identifier
1700092285
Registry record updated May 10, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
050025 Issued in NY
Practice address
501 Main St # a
New York, NY 10044-0190
Phone
(212) 752-8722
Fax
(212) 421-0790
NPI assigned
May 14, 2007
Last updated
May 10, 2010By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 10, 2010

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 050025 NY Primary
Dentist 122300000X 22DI02414200 NJ

Addresses

Primary practice location

501 Main St # a
New York, NY 10044-0190

Mailing address

501 Main St # a
New York, NY 10044-0190
Phone (212) 752-8722

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20150918001815 NY Order and Referring Only - Oral SurgeryPractitioner - Oral SurgeryPractitioner - Other (Physician) 5799092086

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
22DI02414200NJMDDentist

Practice roles

OrganizationSpecialtyStatusNew patients
Metropolitan Dentistry P.C. Dentist Current Accepting new patients
Lawrence M Itskowitch DDS,PC Past Accepting new patients
Dental Passion LLC Dentist Past Accepting new patients

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1179100800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1273449600000",
    "number": "1700092285",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "501 MAIN ST # A",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100440190",
            "telephone_number": "212-752-8722",
            "fax_number": "212-421-0790"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "501 MAIN ST # A",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100440190",
            "telephone_number": "212-752-8722",
            "fax_number": "212-421-0790"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHICK",
        "first_name": "ROBERT",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-05-14",
        "last_updated": "2010-05-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "NY",
            "license": "050025",
            "primary": true
        },
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "NJ",
            "license": "22DI02414200",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

Verify at the official NPI Registry.