NPIMap

Organization Active NPI

Kenneth B Chapman MD PLLC

  • Pain Medicine Physician
  • Staten Island, NY
National Provider Identifier
1811915416
Registry record updated Jul 8, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pain Medicine PhysicianTaxonomy code 208VP0000X
Legal business name
KENNETH B CHAPMAN MD PLLC
Practice address
1360 Hylan Blvd
Staten Island, NY 10305
Phone
(718) 667-3577
Fax
(718) 351-7151
NPI assigned
Jul 18, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2020

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

Authorized official

Name
Kenneth Bradley Chapman, M.D.
Title
Chairman
Phone
(917) 868-3817

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Pain Medicine (Anesthesiology) PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207LP2900X
Pain Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 208VP0000X Primary
Interventional Pain Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 208VP0014X

Addresses

Primary practice location

1360 Hylan Blvd
Staten Island, NY 10305

Mailing address

1360 Hylan Blvd
Staten Island, NY 10305-1922
Phone (917) 868-3817

Other practice location 1

860 5th Ave Ste 1B
New York, NY 10065-5856
Phone (212) 724-7246

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
33D1100696Kenneth B Chapman MD PLLC860 5TH Avenue, New York, NY 10065Certificate of waiverJul 28, 2027

National Provider Directory

National Provider Directory

Locations

1534 Victory Blvd
Lowr
Staten Island, NY 10314
Phone (718) 987-3338

Practitioners & affiliated clinicians

Practitioners 3

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

NPI Registry JSON

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

{
    "created_epoch": "1153180800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1594166400000",
    "number": "1811915416",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1360 HYLAN BLVD",
            "city": "STATEN ISLAND",
            "state": "NY",
            "postal_code": "103051922",
            "telephone_number": "917-868-3817",
            "fax_number": "718-351-7151"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1360 HYLAN BLVD",
            "city": "STATEN ISLAND",
            "state": "NY",
            "postal_code": "10305",
            "telephone_number": "718-667-3577",
            "fax_number": "718-351-7151"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "860 5th Ave Ste 1B",
            "address_purpose": "LOCATION",
            "city": "New York",
            "state": "NY",
            "postal_code": "100655856",
            "country_code": "US",
            "telephone_number": "212-724-7246",
            "fax_number": "718-351-7151",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "KENNETH B CHAPMAN MD PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-18",
        "last_updated": "2020-07-08",
        "certification_date": "2020-07-08",
        "status": "A",
        "authorized_official_last_name": "CHAPMAN",
        "authorized_official_first_name": "KENNETH",
        "authorized_official_middle_name": "BRADLEY",
        "authorized_official_title_or_position": "CHAIRMAN",
        "authorized_official_telephone_number": "917-868-3817",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207LP2900X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Anesthesiology, Pain Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "208VP0000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Pain Medicine, Pain Medicine",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "208VP0014X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Pain Medicine, Interventional Pain Medicine",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Staten Island, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • 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.