Joel P Amidon II, D.O. – Family Medicine Physician

Key facts

NPI: 1922080795
Entity type: Individual (NPI type 1)
Primary specialty: Family Medicine Physician 207Q00000X
License: 174010 (NY)
Practice address: 2 Ellinwood Dr
New Hartford, NY 13413-1102
Phone: (315) 507-5081
NPI assigned: Nov 17, 2005
Sex: Male
Sole proprietor: No

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.

Rome Medical Group, P.C. Family Medicine Physician · Rome, NY · NPI 1407892342

NPD FAMILY MEDICINE

Medicare participation

Medicare fee-for-service enrollment: Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD): Yes
Credentials: Doctor of Osteopathy

Practice roles

Organization	Specialty	Status	New patients
Rome Medical Group, P.C.	Family Medicine	Current	Accepting new patients

Locations

1801 Black River Blvd N
Rome, NY 13440
Phone (315) 337-3770

245 Avery Ln
Rome, NY 13441

Specialties & licenses

Specialty (taxonomy)	Code	License	State	Primary
Family Medicine Physician	207Q00000X	174010	NY	Yes

Addresses

Primary practice location

2 Ellinwood Dr
New Hartford, NY 13413-1102

Mailing address

8293 Turin Rd
Rome, NY 13440-1913
Phone (315) 335-0441

Other identifiers

Identifier	Type	State	Issuer
01077605	Medicaid	NY

Other providers in New Hartford, NY

All providers in New Hartford, NY · Family Medicine Physician in New York

Sources for this page

NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Apr 3, 2014. Information in NPPES is self-reported and not verified by CMS.
NUCC Health Care Provider Taxonomy: specialty names.
National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.