Active NPI
Sarra Gwyn Solomon, MD
- Family Medicine Physician
- Montour Falls, NY
National Provider Identifier
1831164060
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- License
- 189534-1
- Practice address
- 220 Steuben St
Montour Falls, NY 14865-9740 - Phone
- (607) 535-8639
- NPI assigned
- Feb 21, 2006
- Last updated
- Aug 2, 2013
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatrics Physician | 208000000X | 189534-1 | NY | |
| Family Medicine Physician | 207Q00000X | 189534-1 | NY | Primary |
Addresses
Primary practice location
220 Steuben St
Montour Falls, NY 14865-9740
Mailing address
220 Steuben St
Montour Falls, NY 14865-9740
Phone (607) 535-8639
Other identifiers 4
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 02407734 | Medicaid | NY | |
| CC8362 | Other | NY | RR MEDICARE GROUP |
| 0019690080001 | Medicaid | PA | |
| P00026954 | Other | NY | RR MEDICARE PIN |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 189534-1 | NY | MD | Pediatrics Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1140480000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1375401600000",
"number": "1831164060",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "220 STEUBEN ST",
"city": "MONTOUR FALLS",
"state": "NY",
"postal_code": "148659740",
"telephone_number": "607-535-8639"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "220 STEUBEN ST",
"city": "MONTOUR FALLS",
"state": "NY",
"postal_code": "148659740",
"telephone_number": "607-535-8639"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SOLOMON",
"first_name": "SARRA",
"middle_name": "GWYN",
"name_prefix": "Dr.",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-02-21",
"last_updated": "2013-08-02",
"status": "A"
},
"taxonomies": [
{
"code": "208000000X",
"taxonomy_group": "",
"desc": "Pediatrics",
"state": "NY",
"license": "189534-1",
"primary": false
},
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "NY",
"license": "189534-1",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "02407734",
"state": "NY"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "RR MEDICARE GROUP",
"identifier": "CC8362",
"state": "NY"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "0019690080001",
"state": "PA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "RR MEDICARE PIN",
"identifier": "P00026954",
"state": "NY"
}
],
"endpoints": [],
"other_names": []
}Other providers in Montour Falls, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 2, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.