Individual provider Active NPI

Joseph J Logan, DO

  • Anesthesiology Physician
  • Bronxville, NY
National Provider Identifier
1841203775
Registry record updated May 16, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
License
236696 Issued in NY
Practice address
55 Palmer Ave
Bronxville, NY 10708-3403
Phone
(908) 358-9319
NPI assigned
Aug 14, 2006
Last updated
May 16, 2013By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 16, 2013

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology Physician 207L00000X 236696 NY Primary
Anesthesiology Physician 207L00000X 25MB08581500 NJ

Addresses

Primary practice location

55 Palmer Ave
Bronxville, NY 10708-3403

Mailing address

800 Westchester Ave
Suite N-511
Rye Brook, NY 10573-1354
Phone (914) 428-5454

Other identifiers 10

IdentifierTypeStateIssuer
4925799OtherNYCIGNA
7173769OtherNYAETNA - PPO
P3631260OtherNYOXFORD HEALTH PLAN
TINOtherHORIZION HEALTHCARE
2581116OtherNYUNITED HEALTHCARE
4C8142OtherNYHEALTH NET
1503S2OtherNYEMPIRE BC/BS
PENDING 1ST CLAIMOtherNYRAILROAD MEDICARE
1078533OtherNYAETNA - HMO
TINOtherMULTIPLAN

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NJ
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100428000288 NJ Practitioner - Anesthesiology 8325073935 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Anesthesiology
Education
Philadelphia College of Osteopathic Medicine, 2002
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Summit Medical Group PAGroup PAC ID 5395642276, 1,204 clinicians

Practice addresses (Care Compare)

1 Diamond Hill Rd
Berkeley Heights, NJ 07922-2104
Phone (908) 273-4300

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

Practice roles

OrganizationSpecialtyStatusNew patients
Summit Medical Group PA CurrentSince Jan 19, 2011 Accepting new patients
Summit Medical Group PA CurrentSince Jan 19, 2011 Accepting new patients
Westchester Anesthesiologists, P.C. Anesthesiology PastSince Sep 7, 2009 Accepting new patients

Locations

1 Diamond Hill Rd
Berkeley Heights, NJ 07922
Phone (908) 277-8868

Interoperability endpoints

  • Direct secure messaging: joseph.logan.1@2983.direct.athenahealth.com

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1155513600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1368662400000",
    "number": "1841203775",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "800 WESTCHESTER AVE",
            "address_2": "SUITE N-511",
            "city": "RYE BROOK",
            "state": "NY",
            "postal_code": "105731354",
            "telephone_number": "914-428-5454",
            "fax_number": "914-428-5460"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "55 PALMER AVE",
            "city": "BRONXVILLE",
            "state": "NY",
            "postal_code": "107083403",
            "telephone_number": "908-358-9319"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LOGAN",
        "first_name": "JOSEPH",
        "middle_name": "J",
        "name_prefix": "Dr.",
        "credential": "DO",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-08-14",
        "last_updated": "2013-05-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "NY",
            "license": "236696",
            "primary": true
        },
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "NJ",
            "license": "25MB08581500",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CIGNA",
            "identifier": "4925799",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA - PPO",
            "identifier": "7173769",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OXFORD HEALTH PLAN",
            "identifier": "P3631260",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HORIZION HEALTHCARE",
            "identifier": "TIN",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITED HEALTHCARE",
            "identifier": "2581116",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTH NET",
            "identifier": "4C8142",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "EMPIRE BC/BS",
            "identifier": "1503S2",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "PENDING 1ST CLAIM",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA - HMO",
            "identifier": "1078533",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MULTIPLAN",
            "identifier": "TIN",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Bronxville, NY

Sources for this page

Verify at the official NPI Registry.