Northern Medical Group, PLLC

Primary specialty

PodiatristTaxonomy code 213E00000X

Legal business name

NORTHERN MEDICAL GROUP, PLLC

Practice address

400 Westage Business Ctr Dr Ste 211
Fishkill, NY 12524-2267

Phone

(845) 226-4590

Fax

(845) 896-6982

NPI assigned

May 21, 2020

Organization subpart

No

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

Authorized official

Name

Kristina Francese

Title

Credentialing Specialist

Phone

(845) 592-4915

Specialties & licenses 1

Addresses

Other identifiers 1

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

{
    "created_epoch": "1590019200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1590019200000",
    "number": "1831712181",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "111 CLOCK TOWER CMNS",
            "city": "BREWSTER",
            "state": "NY",
            "postal_code": "105094055",
            "telephone_number": "845-279-5187",
            "fax_number": "845-279-5168"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "400 WESTAGE BUSINESS CTR DR STE 211",
            "city": "FISHKILL",
            "state": "NY",
            "postal_code": "125242267",
            "telephone_number": "845-226-4590",
            "fax_number": "845-896-6982"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NORTHERN MEDICAL GROUP, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-05-21",
        "last_updated": "2020-05-21",
        "certification_date": "2020-05-21",
        "status": "A",
        "authorized_official_last_name": "FRANCESE",
        "authorized_official_first_name": "KRISTINA",
        "authorized_official_title_or_position": "CREDENTIALING SPECIALIST",
        "authorized_official_telephone_number": "845-592-4915"
    },
    "taxonomies": [
        {
            "code": "213E00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Podiatrist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "04755717",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Podiatrist in Fishkill, NY
• Providers in Fishkill, NY by specialty
• Podiatrist in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 21, 2020; 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.