Individual provider Active NPI

Daniel P Federowicz, MD

  • Orthopaedic Surgery Physician
  • Johnson City, NY
National Provider Identifier
1902820210
Registry record updated Mar 23, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthopaedic Surgery PhysicianTaxonomy code 207X00000X
License
188755-1 Issued in NY
Practice address
240 Riverside Dr
Johnson City, NY 13790-2732
Phone
(607) 798-9356
Fax
(607) 797-1707
NPI assigned
Jul 27, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 23, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Orthopaedic Surgery Physician 207X00000X 188755-1 NY Primary

Addresses

Primary practice location

240 Riverside Dr
Johnson City, NY 13790-2732

Mailing address

240 Riverside Dr
Johnson City, NY 13790-2732
Phone (607) 798-9356

Other identifiers 1

IdentifierTypeStateIssuer
01342772MedicaidNY

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address DFederowicz@TierOrthopedicAssociates.medentdirect.com Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
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
I20091207000356 NY Practitioner - Orthopedic Surgery 8224082730 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
188755-1NYMDOrthopaedic Surgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Our Lady of Lourdes Memorial Hospital, Inc. CurrentSince Jun 26, 2017 Accepting new patients
Our Lady of Lourdes Memorial Hospital Inc. Current Accepting new patients
Twin Tier Pathology Associates, PC Current Accepting new patients
Our Lady of Lourdes Memorial Hospital, Inc. CurrentSince Jun 26, 2017 Accepting new patients

Locations

169 Riverside Dr
Binghamton, NY 13905
Phone (607) 798-5111

169 Riverside Dr
Ste 206
Binghamton, NY 13905
Phone (607) 798-6701

240 Riverside Dr
Johnson City, NY 13790
Phone (607) 754-3863

Interoperability endpoints

  • Direct secure messaging: dfederowicz196856@direct-guthrie.org
  • Direct secure messaging: dfederowicz@tierorthopedicassociates.medentdirect.com

Organizations & group practices 4

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

NPI Registry JSON

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

{
    "created_epoch": "1153958400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1616457600000",
    "number": "1902820210",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "240 RIVERSIDE DR",
            "city": "JOHNSON CITY",
            "state": "NY",
            "postal_code": "137902732",
            "telephone_number": "607-798-9356",
            "fax_number": "607-797-1707"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "240 RIVERSIDE DR",
            "city": "JOHNSON CITY",
            "state": "NY",
            "postal_code": "137902732",
            "telephone_number": "607-798-9356",
            "fax_number": "607-797-1707"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FEDEROWICZ",
        "first_name": "DANIEL",
        "middle_name": "P",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-27",
        "last_updated": "2021-03-23",
        "certification_date": "2021-03-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207X00000X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery",
            "state": "NY",
            "license": "188755-1",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01342772",
            "state": "NY"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "DFederowicz@TierOrthopedicAssociates.medentdirect.com",
            "affiliation": "N",
            "endpointDescription": "Lourdes Hospital",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "CCDA",
            "address_1": "240 Riverside Dr",
            "city": "Johnson City",
            "state": "NY",
            "country_code": "US",
            "postal_code": "137902732",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Johnson City, NY

Sources for this page

Verify at the official NPI Registry.