North Coast Medical Associates PLLC

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

236459 Issued in NY

Legal business name

NORTH COAST MEDICAL ASSOCIATES PLLC

Practice address

415 Port Washington Blvd
Port Washington, NY 11050-4201

Phone

(516) 883-0218

Fax

(516) 767-0894

NPI assigned

Jun 26, 2007

Organization subpart

No

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

Authorized official

Name

Dr. Anna Lizza Siasoco, MD

Title

Owner

Phone

(516) 883-0218

Specialties & licenses 1

Addresses

Other identifiers 11

Practitioners 1

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

• Vincent Siasoco

  • Specialist
  • New York, NY
  • NPI 1538238316
  NPD (past)

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

{
    "created_epoch": "1182816000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1297900800000",
    "number": "1821294711",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "415 PORT WASHINGTON BLVD",
            "city": "PORT WASHINGTON",
            "state": "NY",
            "postal_code": "110504201",
            "telephone_number": "516-883-0218",
            "fax_number": "516-767-0894"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "415 PORT WASHINGTON BLVD",
            "city": "PORT WASHINGTON",
            "state": "NY",
            "postal_code": "110504201",
            "telephone_number": "516-883-0218",
            "fax_number": "516-767-0894"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NORTH COAST MEDICAL ASSOCIATES PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-06-26",
        "last_updated": "2011-02-17",
        "status": "A",
        "authorized_official_last_name": "SIASOCO",
        "authorized_official_first_name": "ANNA",
        "authorized_official_middle_name": "LIZZA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "516-883-0218",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": "NY",
            "license": "236459",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "3363P1",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTH NET OF NORTHEAST",
            "identifier": "6C0603",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ATLANTIS",
            "identifier": "SA6459",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OXFORD",
            "identifier": "P3698445",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CIGNA",
            "identifier": "5880458",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GHI",
            "identifier": "5995775",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MDNY",
            "identifier": "AA73558A",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HIP",
            "identifier": "286811P",
            "state": "NM"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PHCS",
            "identifier": "9412517",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MAGNACARE",
            "identifier": "051903998",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UHC",
            "identifier": "2554307",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Family Medicine Physician in Port Washington, NY
• Providers in Port Washington, NY by specialty
• Family Medicine Physician in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 17, 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.