Organization Active NPI

Western Nassau Orthopaedic Assoc P.C.

  • Orthopaedic Surgery Physician
  • Mineola, NY
National Provider Identifier
1871772269
Registry record updated Aug 5, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthopaedic Surgery PhysicianTaxonomy code 207X00000X
Legal business name
WESTERN NASSAU ORTHOPAEDIC ASSOC P.C.
Practice address
137 Willis Ave
Mineola, NY 11501-2658
Phone
(516) 741-8822
Fax
(516) 741-4903
NPI assigned
Nov 1, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 5, 2010

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

Authorized official

Name
Dr. Philip Fontanetta, M.D.
Title
President
Phone
(516) 741-8822

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Orthopaedic Surgery PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207X00000X Primary

Addresses

Primary practice location

137 Willis Ave
Mineola, NY 11501-2658

Mailing address

137 Willis Ave
Mineola, NY 11501-2658
Phone (516) 741-8822

Other identifiers 1

IdentifierTypeStateIssuer
C20528OtherRAILROAD MEDICARE

National Provider Directory

National Provider Directory

Locations

137 Willis Ave
Ste 110
Mineola, NY 11501
Phone (516) 741-8822

NPI Registry JSON

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

{
    "created_epoch": "1193875200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1280966400000",
    "number": "1871772269",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "137 WILLIS AVE",
            "city": "MINEOLA",
            "state": "NY",
            "postal_code": "115012658",
            "telephone_number": "516-741-8822",
            "fax_number": "516-741-4903"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "137 WILLIS AVE",
            "city": "MINEOLA",
            "state": "NY",
            "postal_code": "115012658",
            "telephone_number": "516-741-8822",
            "fax_number": "516-741-4903"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WESTERN NASSAU ORTHOPAEDIC ASSOC P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-11-01",
        "last_updated": "2010-08-05",
        "status": "A",
        "authorized_official_last_name": "FONTANETTA",
        "authorized_official_first_name": "PHILIP",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "516-741-8822",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207X00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Orthopaedic Surgery",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "C20528",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Mineola, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 5, 2010; 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.