123 Medical Group, P.C.

Primary specialty

SpecialistTaxonomy code 174400000X

Legal business name

123 MEDICAL GROUP, P.C.

Practice address

286 Fort Washington Ave
Suite# 1G
New York, NY 10032-1315

Phone

(212) 543-1800

NPI assigned

Apr 17, 2013

Organization subpart

No

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

Authorized official

Name

Dr. Alcibiades Rodriguez, MDNPI 1831151281

Title

President

Phone

(212) 543-1800

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in NY

Enrollment records 1

Locations

Practitioners 2

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

• Alcibiades J. Rodriguez, MD

  • Clinical Neurophysiology Physician
  • New York, NY
  • NPI 1831151281
  Medicare reassignment Authorized official
• Sana Chaudry, MD

  • Pediatrics Physician
  • Norwalk, CT
  • NPI 1528649159

  NY

  Medicare reassignment

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

{
    "created_epoch": "1366156800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1366156800000",
    "number": "1952745291",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "286 FORT WASHINGTON AVE",
            "address_2": "SUITE# 1G",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100321315",
            "telephone_number": "212-543-1800"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "286 FORT WASHINGTON AVE",
            "address_2": "SUITE# 1G",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100321315",
            "telephone_number": "212-543-1800"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "123 MEDICAL GROUP, P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-04-17",
        "last_updated": "2013-04-17",
        "status": "A",
        "authorized_official_last_name": "RODRIGUEZ",
        "authorized_official_first_name": "ALCIBIADES",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "212-543-1800",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Specialist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Specialist in New York, NY
• Providers in New York, NY by specialty
• Specialist in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 17, 2013; 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.

Verify at the official NPI Registry.