NPIMap

Organization Active NPI

Civic Medicine, PLLC

  • Infusion Therapy Clinic/Center
  • Valhalla, NY
National Provider Identifier
1801404553
Registry record updated Jul 20, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Infusion Therapy Clinic/CenterTaxonomy code 261QI0500X
Legal business name
CIVIC MEDICINE, PLLC
Practice address
400 Columbus Ave
Valhalla, NY 10595-1305
Phone
(203) 883-0038
Fax
(203) 724-4838
NPI assigned
Jul 20, 2020
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 20, 2020

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

Authorized official

Name
Barry Stein, MDNPI 1952318487
Title
Partner
Phone
(203) 883-0038

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
Infusion Therapy Clinic/Center 261QI0500X Primary

Addresses

Primary practice location

400 Columbus Ave
Valhalla, NY 10595-1305

Mailing address

249 Danbury Rd
Wilton, CT 06897-4010
Phone (203) 883-0038

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20201014003715 NY Part B Supplier - Clinic/Group Practice 0345660254 Receives reassigned benefits from 22 practitioners
Practice locations: Valhalla, NY

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
33D2291643Civic Medicine PLLC400 Columbus Avenue, Ste 105S, Valhalla, NY 10595Certificate of waiverOct 12, 2027

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 23

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

View all 23

NPI Registry JSON

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

{
    "created_epoch": "1595203200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1595203200000",
    "number": "1801404553",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "249 DANBURY RD",
            "city": "WILTON",
            "state": "CT",
            "postal_code": "068974010",
            "telephone_number": "203-883-0038",
            "fax_number": "203-724-4838"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "400 COLUMBUS AVE",
            "city": "VALHALLA",
            "state": "NY",
            "postal_code": "105951305",
            "telephone_number": "203-883-0038",
            "fax_number": "203-724-4838"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CIVIC MEDICINE, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-07-20",
        "last_updated": "2020-07-20",
        "certification_date": "2020-07-20",
        "status": "A",
        "authorized_official_last_name": "STEIN",
        "authorized_official_first_name": "BARRY",
        "authorized_official_title_or_position": "PARTNER",
        "authorized_official_telephone_number": "203-883-0038",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "261QI0500X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Infusion Therapy",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Valhalla, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 20, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.