St. Nicholas Pediatrics, PC

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

Legal business name

ST. NICHOLAS PEDIATRICS, PC

Practice address

1559 Saint Nicholas Ave
New York, NY 10040-4261

Phone

(212) 928-8188

Fax

(212) 929-8040

NPI assigned

Jan 11, 2007

Organization subpart

No

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

Authorized official

Name

Hector Antonio Valencia, M.D.

Title

Owner

Phone

(212) 928-8188

Specialties & licenses 1

Addresses

Other identifiers 1

Tax ID family

St Nicholas Pediatrics PC2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• St. Nicholas Pediatrics, PC

  • Pediatrics Physician
  • Bronx, NY
  • NPI 1568512408
  NPD tax ID

Locations

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

{
    "created_epoch": "1168473600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1962552802",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3230 156TH ST",
            "city": "FLUSHING",
            "state": "NY",
            "postal_code": "113543326",
            "telephone_number": "212-928-8188",
            "fax_number": "212-928-8040"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1559 SAINT NICHOLAS AVE",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100404261",
            "telephone_number": "212-928-8188",
            "fax_number": "212-929-8040"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ST. NICHOLAS PEDIATRICS, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-11",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "VALENCIA",
        "authorized_official_first_name": "HECTOR",
        "authorized_official_middle_name": "ANTONIO",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "212-928-8188",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Pediatrics",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02219529",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• St. Marks Place
• St. Mary'S Center, Inc
• St. Mary'S Center, Inc
• St. Marys Center Inc
• St. Nicholas Medical of New York, LLC
• St. Nicholas Professional Medical Services of New York LLC
• Sarah Jean St. Onge, PH.D.
• Ryan Edward St. Pierre-Hetz, MD
• Tara-Germaine St. Rose, NP
• St. Vincent Catholic Medical Center

• All providers in New York, NY
• Pediatrics Physician in New York

• 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.