NPIMap

Organization Active NPI

Elliot Professional Services

  • Surgery Physician
  • Manchester, NH
National Provider Identifier
1821246976
Registry record updated Sep 4, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
Legal business name
ELLIOT PROFESSIONAL SERVICES
Practice address
4 Elliot Way
Suite 201
Manchester, NH 03103-3547
Phone
(603) 623-3836
Fax
(603) 623-4611
NPI assigned
Sep 3, 2008
Last updated
Sep 4, 2008By the provider in NPPES
Organization subpart
Yes
Parent organization
ELLIOT PROFESSIONAL SERVICESAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Sep 4, 2008

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

Authorized official

Name
Richard P Herman
Title
Director of Operations and Finance
Phone
(603) 663-4904

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery Physician 208600000X NU Primary

Addresses

Primary practice location

4 Elliot Way
Suite 201
Manchester, NH 03103-3547

Mailing address

4 Elliot Way
Suite 201
Manchester, NH 03103-3547
Phone (603) 623-3836

Other identifiers 1

IdentifierTypeStateIssuer
CK3360OtherNHRR MEDICARE

Other names 1

  • Marc S. Rubenson, MD Other name

National Provider Directory

National Provider Directory
Tax ID family
Elliot Professional Ser35 organizations share this tax ID, including this one
Part of
Elliot Professional Ser

Other organizations with this tax ID 34

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

View all 34

Locations

4 Elliot Way
Ste 201
Manchester, NH 03103
Phone (603) 623-3836

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 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1220400000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1220486400000",
    "number": "1821246976",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4 ELLIOT WAY",
            "address_2": "SUITE 201",
            "city": "MANCHESTER",
            "state": "NH",
            "postal_code": "031033547",
            "telephone_number": "603-623-3836",
            "fax_number": "603-623-4611"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4 ELLIOT WAY",
            "address_2": "SUITE 201",
            "city": "MANCHESTER",
            "state": "NH",
            "postal_code": "031033547",
            "telephone_number": "603-623-3836",
            "fax_number": "603-623-4611"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ELLIOT PROFESSIONAL SERVICES",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "ELLIOT PROFESSIONAL SERVICES",
        "enumeration_date": "2008-09-03",
        "last_updated": "2008-09-04",
        "status": "A",
        "authorized_official_last_name": "HERMAN",
        "authorized_official_first_name": "RICHARD",
        "authorized_official_middle_name": "P",
        "authorized_official_title_or_position": "DIRECTOR OF OPERATIONS AND FINANCE",
        "authorized_official_telephone_number": "603-663-4904"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE",
            "identifier": "CK3360",
            "state": "NH"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Marc S. Rubenson, MD",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Manchester, NH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 4, 2008; 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.