SRB Plastic Surgery PC

Primary specialty

Plastic Surgery PhysicianTaxonomy code 208200000X

License

166718 Issued in NY

Legal business name

SRB PLASTIC SURGERY PC

Practice address

740 Park Ave
New York, NY 10021-4251

Phone

(212) 879-7900

NPI assigned

May 23, 2007

Last updated

Jun 16, 2018By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Stafford R Broumand, M.D.NPI 1548313828

Title

President

Phone

(212) 879-7900

Specialties & licenses 1

Addresses

Other identifiers 4

Medicare fee-for-service enrollment

Enrolled in NY

Enrollment records 1

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.

• Stafford R Broumand, M.D.

  • Plastic Surgery Physician
  • New York City, NY
  • NPI 1548313828
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1179878400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1529107200000",
    "number": "1962612507",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "SRB PLASTIC SURGERY PC",
            "address_2": "75 E 71ST STREET",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100214251",
            "telephone_number": "212-879-7900"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "740 PARK AVE",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100214251",
            "telephone_number": "212-879-7900"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SRB PLASTIC SURGERY PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-23",
        "last_updated": "2018-06-16",
        "status": "A",
        "authorized_official_last_name": "BROUMAND",
        "authorized_official_first_name": "STAFFORD",
        "authorized_official_middle_name": "R",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "212-879-7900",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "208200000X",
            "taxonomy_group": "",
            "desc": "Plastic Surgery",
            "state": "NY",
            "license": "166718",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "80H671",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GHI",
            "identifier": "0100923",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTH NET",
            "identifier": "N37868",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OXFORD",
            "identifier": "P3806444",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Natalie A Squires, MD
• Stephanie Squittieri, AUD, CCC-A
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• Sravisht Iyer MD PC
• Aditya Sreenivasan, M.D.
• Venkatesh Sreeram, MD
• Sreeven Pharmacy Inc
• Jaouad Srerho
• Monvadi Barbara Srichai-Parsia, M.D.

• Plastic Surgery Physician in New York, NY
• Providers in New York, NY by specialty
• Plastic Surgery Physician in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 16, 2018; 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.