NPIMap

Organization Active NPI

Northeast Orthopedics & Sports Medicine PLLC

  • Sports Medicine (Orthopaedic Surgery) Physician
  • Orangeburg, NY
National Provider Identifier
1871902544
Registry record updated Aug 7, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Sports Medicine (Orthopaedic Surgery) PhysicianTaxonomy code 207XX0005X
Legal business name
NORTHEAST ORTHOPEDICS & SPORTS MEDICINE PLLC
Practice address
99 Dutch Hill Rd
Orangeburg, NY 10962-2185
Phone
(845) 359-1877
Fax
(845) 262-5313
NPI assigned
Aug 7, 2014
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 7, 2014

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

Authorized official

Name
Dr. Jordon A Simon, MD
Title
MD/Owner
Phone
(845) 359-1877

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Sports Medicine (Orthopaedic Surgery) PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207XX0005X Primary
Durable Medical Equipment & Medical Supplies 332B00000X

Addresses

Primary practice location

99 Dutch Hill Rd
Orangeburg, NY 10962-2185

Mailing address

99 Dutch Hill Rd
Orangeburg, NY 10962-2185
Phone (845) 359-1877

Other names 1

  • NEOSM Other name

National Provider Directory

National Provider Directory
Tax ID family
Northeast Orthopedics and Sports Medicine PLLC3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

Organizations that report the same tax identification number in the National Provider Directory.

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/2245/brand/2/csg/81/fhir/r4

NPI Registry JSON

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

{
    "created_epoch": "1407369600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1407369600000",
    "number": "1871902544",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "99 DUTCH HILL RD",
            "city": "ORANGEBURG",
            "state": "NY",
            "postal_code": "109622185",
            "telephone_number": "845-359-1877",
            "fax_number": "845-262-5313"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "99 DUTCH HILL RD",
            "city": "ORANGEBURG",
            "state": "NY",
            "postal_code": "109622185",
            "telephone_number": "845-359-1877",
            "fax_number": "845-262-5313"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NORTHEAST ORTHOPEDICS & SPORTS MEDICINE PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-08-07",
        "last_updated": "2014-08-07",
        "status": "A",
        "authorized_official_last_name": "SIMON",
        "authorized_official_first_name": "JORDON",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "MD/OWNER",
        "authorized_official_telephone_number": "845-359-1877",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207XX0005X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Orthopaedic Surgery, Sports Medicine",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "NEOSM",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Orangeburg, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 7, 2014; 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.