NPIMap

Organization Active NPI

North Country Ec LLC

  • Certified Registered Nurse Anesthetist
  • Wilton, NY
National Provider Identifier
1760171680
Registry record updated Sep 2, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
Legal business name
NORTH COUNTRY EC LLC
Practice address
135 North Rd BLDG 2
Wilton, NY 12831-1308
Phone
(518) 450-1304
NPI assigned
May 5, 2023
Last updated
Sep 2, 2024By the provider in NPPES
Organization subpart
Yes
Parent organization
NORTH COUNTRY EC LLCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Sep 2, 2024

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

Authorized official

Name
Timothy Duffey
Title
Exceutive Director
Phone
(518) 450-1304

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207L00000X
Certified Registered Nurse AnesthetistGroup: 193200000X MULTI-SPECIALTY GROUP 367500000X Primary

Addresses

Primary practice location

135 North Rd BLDG 2
Wilton, NY 12831-1308

Mailing address

PO Box 2005
East Syracuse, NY 13057-4505
Phone (315) 449-0513

Other names 1

  • NE NY Anesth Providers Other name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20230525001661 NY Part B Supplier - Clinic/Group Practice 9436395910 Receives reassigned benefits from 13 practitioners
Practice locations: Wilton, NY

National Provider Directory

National Provider Directory
Tax ID family
North Country Ec LLC2 organizations share this tax ID, including this one
Part of
North Country Ec LLC

Other organizations with this tax ID 1

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

Ownership & related parties

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

Practitioners & affiliated clinicians

Practitioners 14

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.

View all 14

NPI Registry JSON

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

{
    "created_epoch": "1683244800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1725235200000",
    "number": "1760171680",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2005",
            "city": "EAST SYRACUSE",
            "state": "NY",
            "postal_code": "130574505",
            "telephone_number": "315-449-0513",
            "fax_number": "315-362-5120"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "135 NORTH RD BLDG 2",
            "city": "WILTON",
            "state": "NY",
            "postal_code": "128311308",
            "telephone_number": "518-450-1304"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NORTH COUNTRY EC LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "NORTH COUNTRY EC LLC",
        "enumeration_date": "2023-05-05",
        "last_updated": "2024-09-02",
        "certification_date": "2024-09-02",
        "status": "A",
        "authorized_official_last_name": "DUFFEY",
        "authorized_official_first_name": "TIMOTHY",
        "authorized_official_title_or_position": "EXCEUTIVE DIRECTOR",
        "authorized_official_telephone_number": "518-450-1304"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Anesthesiology",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "367500000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "NE NY Anesth Providers",
            "code": "5",
            "type": "Other Name"
        },
        {
            "organization_name": "NE NY Anesth Providers",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Wilton, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 2, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.