David Randall Dynof, MD

Primary specialty

Sports Medicine (Orthopaedic Surgery) PhysicianTaxonomy code 207XX0005X

License

225074-1 Issued in NY

Practice address

2 Coraci Blvd
Ste 1
Shirley, NY 11967-4833

Phone

(212) 682-2750

Fax

(212) 682-6588

NPI assigned

Aug 2, 2005

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

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

Specialty

Orthopedic SurgeryAlso: Pain Management

Education

New York Medical College, 2000

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

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.

• DRD Medical PC

  • Pain Medicine Physician
  • New York, NY
  • NPI 1205045853
  Medicare reassignment NPD Authorized official
• All Body Medical PC

  • Pain Medicine Physician
  • Yonkers, NY
  • NPI 1750094306
  NPD Authorized official
• Nirmala M Reddy, MD

  • Specialist
  • Yonkers, NY
  • NPI 1962522292
  NPD (past)
• Physicians Medical PC

  • Podiatrist
  • New York, NY
  • NPI 1083979694
  NPD (past)
• Sycamore Medical PC

  • Clinic/Center
  • New York, NY
  • NPI 1598334534
  NPD (past)

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

{
    "created_epoch": "1122940800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1519171200000",
    "number": "1912908989",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2341 BELLMORE AVE",
            "city": "BELLMORE",
            "state": "NY",
            "postal_code": "117105624",
            "telephone_number": "516-781-8100",
            "fax_number": "516-781-8133"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2 CORACI BLVD",
            "address_2": "STE 1",
            "city": "SHIRLEY",
            "state": "NY",
            "postal_code": "119674833",
            "telephone_number": "212-682-2750",
            "fax_number": "212-682-6588"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DYNOF",
        "first_name": "DAVID",
        "middle_name": "RANDALL",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-08-02",
        "last_updated": "2018-02-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207XX0005X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery, Sports Medicine",
            "state": "NY",
            "license": "225074-1",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02613927",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Amanda Drenzyk, BCBA
• Kimberly Duffy, MD
• Dummuzi Christopher Duhaney, LMSW
• Tara Dunn
• Liliya Dyakiv, PTA
• Eastern Island Medical Care PC
• Kimberly Edwards
• Tracy L Egger, LCSW
• Noha Aladdin Elfar, OTR/L
• Debbie-Ann Katheen Ellington-Tulloch, APRN

• Sports Medicine (Orthopaedic Surgery) Physician in Shirley, NY
• Providers in Shirley, NY by specialty
• Sports Medicine (Orthopaedic Surgery) Physician in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 21, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.