Individual provider Active NPI

Joel Bruce Fieldman, M.D.

  • Anesthesiology Physician
  • Roslyn HTS, NY
National Provider Identifier
1912068008
Registry record updated May 7, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
License
193719 Issued in NY
Practice address
40 Turf LN
Roslyn HTS, NY 11577-2738
Phone
(718) 416-4389
Fax
(718) 416-3652
NPI assigned
Dec 12, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 7, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology Physician 207L00000X 193719 NY Primary

Addresses

Primary practice location

40 Turf LN
Roslyn HTS, NY 11577-2738

Mailing address

40 Turf LN
Roslyn HTS, NY 11577-2738
Phone (718) 416-4389

Other identifiers 1

IdentifierTypeStateIssuer
01666320MedicaidNY

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
I20050228000214 NY Practitioner - Anesthesiology 7618920927 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Anesthesiology
Education
State University of Ny Upstate Medical University, 1982
Medicare assignment
May accept Medicare assignment
Group practices
Joel Bruce Fieldman MD PCGroup PAC ID 1951553411, 2 clinicians

Practice addresses (Care Compare)

104 -60 Queens Blvd
Forest Hills, NY 11375-7318
Phone (718) 897-2121

20 W Lincoln Ave
Suite 201
Valley Stream, NY 11580-5731
Phone (516) 872-3885

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
193719NYMDAnesthesiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Joel Bruce Fieldman MD P.C. Anesthesiology CurrentSince Jan 1, 2012 Accepting new patients

Locations

11204 Queens Blvd
Forest Hills, NY 11375
Phone (718) 263-6083

18904 Union Tpke
Fresh Meadows, NY 11366
Phone (718) 217-1414

210 E Sunrise Hwy
Valley Stream, NY 11581
Phone (516) 825-8484

20 W Lincoln Ave
Ste 201
Valley Stream, NY 11580
Phone (516) 872-3885

Organizations & group practices 1

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": "1165881600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1210118400000",
    "number": "1912068008",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "40 TURF LN",
            "city": "ROSLYN HTS",
            "state": "NY",
            "postal_code": "115772738",
            "telephone_number": "718-416-4389",
            "fax_number": "718-416-3652"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "40 TURF LN",
            "city": "ROSLYN HTS",
            "state": "NY",
            "postal_code": "115772738",
            "telephone_number": "718-416-4389",
            "fax_number": "718-416-3652"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FIELDMAN",
        "first_name": "JOEL",
        "middle_name": "BRUCE",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-12-12",
        "last_updated": "2008-05-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "NY",
            "license": "193719",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01666320",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Roslyn HTS, NY

Sources for this page

Verify at the official NPI Registry.