NPIMap

Organization Active NPI

Bardonia Pediatric Assoc

  • Pediatrics Physician
  • Bardonia, NY
National Provider Identifier
1942385299
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
Legal business name
BARDONIA PEDIATRIC ASSOC
Practice address
446 Route 304
Bardonia, NY 10954-1617
Phone
(845) 623-8031
Fax
(845) 624-0928
NPI assigned
Oct 26, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Ms. Ronnie Kossoff
Title
Billing Manager
Phone
(845) 623-8031

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics PhysicianGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 208000000X Primary

Addresses

Primary practice location

446 Route 304
Bardonia, NY 10954-1617

Mailing address

446 Route 304
Bardonia, NY 10954-1617
Phone (845) 623-8031

Other identifiers 1

IdentifierTypeStateIssuer
00520223MedicaidNY

National Provider Directory

National Provider Directory

Locations

446 Route 304
Bardonia, NY 10954
Phone (845) 623-6666

Practitioners & affiliated clinicians

Practitioners 5

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1161820800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1942385299",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "446 ROUTE 304",
            "city": "BARDONIA",
            "state": "NY",
            "postal_code": "109541617",
            "telephone_number": "845-623-8031",
            "fax_number": "845-624-0928"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "446 ROUTE 304",
            "city": "BARDONIA",
            "state": "NY",
            "postal_code": "109541617",
            "telephone_number": "845-623-8031",
            "fax_number": "845-624-0928"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BARDONIA PEDIATRIC ASSOC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-26",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "KOSSOFF",
        "authorized_official_first_name": "RONNIE",
        "authorized_official_title_or_position": "BILLING MANAGER",
        "authorized_official_telephone_number": "845-623-8031",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Pediatrics",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00520223",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Bardonia, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.