Sports & Orthopedic Surgery of New York, PLLC

Primary specialty

SpecialistTaxonomy code 174400000X

License

217407 Issued in NY

Legal business name

SPORTS & ORTHOPEDIC SURGERY OF NEW YORK, PLLC

Practice address

205 E 16TH St
Suite M1B
New York, NY 10003-3746

Phone

(212) 254-0946

Fax

(212) 254-0956

NPI assigned

Jun 29, 2007

Organization subpart

No

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

Authorized official

Name

Ivan J Fernandez-Madrid, M.D.

Title

Sole Proprietor

Phone

(212) 254-0946

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1183075200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1299456000000",
    "number": "1871790071",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 6402",
            "city": "ITHACA",
            "state": "NY",
            "postal_code": "148516402",
            "telephone_number": "212-254-0946",
            "fax_number": "212-254-0956"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "205 E 16TH ST",
            "address_2": "SUITE M1B",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100033746",
            "telephone_number": "212-254-0946",
            "fax_number": "212-254-0956"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SPORTS & ORTHOPEDIC SURGERY OF NEW YORK, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-06-29",
        "last_updated": "2011-03-07",
        "status": "A",
        "authorized_official_last_name": "FERNANDEZ-MADRID",
        "authorized_official_first_name": "IVAN",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "SOLE PROPRIETOR",
        "authorized_official_telephone_number": "212-254-0946",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Specialist",
            "state": "NY",
            "license": "217407",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Specialist in New York, NY
• Providers in New York, NY by specialty
• Specialist in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 7, 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.