NPIMap

Organization Active NPI

Sedation Vacation Perioperative Medicine PLLC

  • Specialist
  • Valley Stream, NY
National Provider Identifier
1891235404
Registry record updated Apr 18, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
245594 Issued in NY
Legal business name
SEDATION VACATION PERIOPERATIVE MEDICINE PLLC
Practice address
811 Wilson St
Valley Stream, NY 11581-3527
Phone
(718) 550-8600
NPI assigned
Mar 1, 2017
Last updated
Apr 18, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 18, 2024

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

Authorized official

Name
Dr. Avishai T Neuman, M.D.NPI 1093908022
Title
Ceo
Phone
(718) 550-8600

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X 245594 NY Primary

Addresses

Primary practice location

811 Wilson St
Valley Stream, NY 11581-3527

Mailing address

811 Wilson St
Valley Stream, NY 11581-3527
Phone (718) 550-8600

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY, CT, PA, NJ, NH, IL6 enrollments

Enrollment records 6

Enrollment IDStateProvider typePAC IDDetails
O20170525001955 NY Part B Supplier - Clinic/Group Practice 1759658594 Receives reassigned benefits from 297 practitioners
Practice locations: Brooklyn, NY; Le Roy, NY; Ozone Park, NY
O20220106000094 CT Part B Supplier - Clinic/Group Practice 1759658594 Receives reassigned benefits from 1 practitioner
Practice locations: Middletown, CT; Norwalk, CT
O20220113000035 PA Part B Supplier - Clinic/Group Practice 1759658594 Receives reassigned benefits from 13 practitioners
Practice locations: Butztown, PA; Holland, PA
O20220311000226 NJ Part B Supplier - Clinic/Group Practice 1759658594 Receives reassigned benefits from 8 practitioners
Practice locations: Belleville, NJ; Orange, NJ
O20220422000220 NH Part B Supplier - Clinic/Group Practice 1759658594 Receives reassigned benefits from 1 practitioner
Practice locations: Salem, NH
O20220608000306 IL Part B Supplier - Clinic/Group Practice 1759658594 Receives reassigned benefits from 1 practitioner
Practice locations: Chicago, IL

National Provider Directory

National Provider Directory

Locations

540 Saybrook Rd
Middletown, CT 06457
Phone (860) 347-7491

41 W Ida B Wells Dr
Chicago, IL 60605

272 Main St
#B
Orange, NJ 07050

404 2nd Street Pike
Holland, PA 18966

Practitioners & affiliated clinicians

Practitioners 338

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 338

NPI Registry JSON

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

{
    "created_epoch": "1488326400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1713398400000",
    "number": "1891235404",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "811 WILSON ST",
            "city": "VALLEY STREAM",
            "state": "NY",
            "postal_code": "115813527",
            "telephone_number": "718-550-8600"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "811 WILSON ST",
            "city": "VALLEY STREAM",
            "state": "NY",
            "postal_code": "115813527",
            "telephone_number": "718-550-8600"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SEDATION VACATION PERIOPERATIVE MEDICINE PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-03-01",
        "last_updated": "2024-04-18",
        "certification_date": "2024-03-13",
        "status": "A",
        "authorized_official_last_name": "NEUMAN",
        "authorized_official_first_name": "AVISHAI",
        "authorized_official_middle_name": "T",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "718-550-8600",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "NY",
            "license": "245594",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Valley Stream, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 18, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.