Active NPI
Keith S. Fisher, D.D.S.
- Oral and Maxillofacial Surgery (Dentist)
- New York, NY
National Provider Identifier
1740367101
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Oral and Maxillofacial Surgery (Dentist)
- License
- 044131
- Practice address
- 30 Central Park S
Suite 5C
New York, NY 10019-1628 - Phone
- (212) 813-1780
- Fax
- (212) 644-8266
- NPI assigned
- Nov 1, 2006
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Oral and Maxillofacial Surgery (Dentist) | 1223S0112X | 044131 | NY | Primary |
Addresses
Primary practice location
30 Central Park S
Suite 5C
New York, NY 10019-1628
Mailing address
30 Central Park S
Suite 5C
New York, NY 10019-1628
Phone (212) 813-1780
Other identifiers 5
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 3032829 | Other | AETNA | |
| 01690495 | Medicaid | NY | |
| 245824 | Other | CIGNA | |
| 42531 | Other | DHA | |
| 5832282 | Other | DMO |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 044131 | NY | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1162339200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1740367101",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "30 CENTRAL PARK S",
"address_2": "SUITE 5C",
"city": "NEW YORK",
"state": "NY",
"postal_code": "100191628",
"telephone_number": "212-813-1780",
"fax_number": "212-644-8266"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "30 CENTRAL PARK S",
"address_2": "SUITE 5C",
"city": "NEW YORK",
"state": "NY",
"postal_code": "100191628",
"telephone_number": "212-813-1780",
"fax_number": "212-644-8266"
}
],
"practiceLocations": [],
"basic": {
"last_name": "FISHER",
"first_name": "KEITH",
"middle_name": "S.",
"name_prefix": "Dr.",
"credential": "D.D.S.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-11-01",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "1223S0112X",
"taxonomy_group": "",
"desc": "Dentist, Oral and Maxillofacial Surgery",
"state": "NY",
"license": "044131",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "AETNA",
"identifier": "3032829",
"state": null
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "01690495",
"state": "NY"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "CIGNA",
"identifier": "245824",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "DHA",
"identifier": "42531",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "DMO",
"identifier": "5832282",
"state": null
}
],
"endpoints": [],
"other_names": []
}Other providers in New York, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.