Active NPI
Fifth Avenue Surgical Specialists PLLC
- Surgery Physician
- Teaneck, NJ
National Provider Identifier
1932987740
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Surgery Physician
- Legal business name
- FIFTH AVENUE SURGICAL SPECIALISTS PLLC
- Practice address
- 185 Cedar LN Ste L1
Teaneck, NJ 07666-4303 - Phone
- (201) 357-8888
- Fax
- (201) 648-2808
- NPI assigned
- Sep 21, 2023
- Last updated
- Sep 21, 2023
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Paul Tsoukalas
- Title
- Director
- Phone
- (718) 626-0707
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Surgery Physician | 208600000X | NU | Primary |
Addresses
Primary practice location
185 Cedar LN Ste L1
Teaneck, NJ 07666-4303
Mailing address
185 Cedar LN Ste L1
Teaneck, NJ 07666-4303
Phone (201) 357-8888
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in NJ
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20231204002541 | NJ | Part B Supplier - Clinic/Group Practice | 3678921483 |
Receives reassigned benefits from 1 practitioner Practice locations: Teaneck, NJ |
Other NPIs with the same Medicare PAC ID 1
NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).
National Provider Directory
National Provider Directory- Tax ID family
- Fifth Avenue Surgical Specialists PLLC
Other organizations with this tax ID 2
Organizations that report the same tax identification number in the National Provider Directory.
-
- Surgery Physician
- Oyster Bay, NY
- NPI 1134855901
-
- Surgery Physician
- Greenwich, CT
- NPI 1235853649
Practitioners & affiliated clinicians
Practitioners 1
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.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1695254400000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1695254400000",
"number": "1932987740",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "185 CEDAR LN STE L1",
"city": "TEANECK",
"state": "NJ",
"postal_code": "076664303",
"telephone_number": "201-357-8888",
"fax_number": "201-648-2808"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "185 CEDAR LN STE L1",
"city": "TEANECK",
"state": "NJ",
"postal_code": "076664303",
"telephone_number": "201-357-8888",
"fax_number": "201-648-2808"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "FIFTH AVENUE SURGICAL SPECIALISTS PLLC",
"organizational_subpart": "NO",
"enumeration_date": "2023-09-21",
"last_updated": "2023-09-21",
"certification_date": "2023-09-21",
"status": "A",
"authorized_official_last_name": "TSOUKALAS",
"authorized_official_first_name": "PAUL",
"authorized_official_title_or_position": "DIRECTOR",
"authorized_official_telephone_number": "718-626-0707"
},
"taxonomies": [
{
"code": "208600000X",
"taxonomy_group": "",
"desc": "Surgery",
"state": "NU",
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Teaneck, NJ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 21, 2023; 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.