Professional Evaluation Medical Group

Primary specialty

Exclusive Provider OrganizationTaxonomy code 302F00000X

License

147150 Issued in NY

Legal business name

PROFESSIONAL EVALUATION MEDICAL GROUP

Practice address

229 W 36TH St FL 10
New York, NY 10018-8949

Phone

(212) 463-8605

Fax

(212) 463-8579

NPI assigned

Mar 13, 2007

Last updated

Nov 10, 2011By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mr. James Michael Sheehy

Title

Executive Director

Phone

(516) 935-1730

Specialties & licenses 1

Addresses

Tax ID family

Professional Evaluation Medical Group2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

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

• Professional Evaluation Medical Group

  • Exclusive Provider Organization
  • Hicksville, NY
  • NPI 1104960962
  NPD tax ID

Locations

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

{
    "created_epoch": "1173744000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1320883200000",
    "number": "1790818573",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "380 S BROADWAY",
            "city": "HICKSVILLE",
            "state": "NY",
            "postal_code": "118015033",
            "telephone_number": "516-935-4378",
            "fax_number": "516-931-3117"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "229 W 36TH ST FL 10",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100188949",
            "telephone_number": "212-463-8605",
            "fax_number": "212-463-8579"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PROFESSIONAL EVALUATION MEDICAL GROUP",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-13",
        "last_updated": "2011-11-10",
        "status": "A",
        "authorized_official_last_name": "SHEEHY",
        "authorized_official_first_name": "JAMES",
        "authorized_official_middle_name": "MICHAEL",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "516-935-1730",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "302F00000X",
            "taxonomy_group": "",
            "desc": "Exclusive Provider Organization",
            "state": "NY",
            "license": "147150",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Professional Monitoring and Testing Associates PC

• Exclusive Provider Organization in New York, NY
• Providers in New York, NY by specialty
• Exclusive Provider Organization in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 10, 2011; 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.