Individual provider Active NPI

Jeremy Varnum Pulsifer, M.S.T.O.M., L.AC.

  • Acupuncturist
  • New York, NY
National Provider Identifier
1982884151
Registry record updated Nov 5, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
AcupuncturistTaxonomy code 171100000X
License
25-003224 Issued in NY
Practice address
30 E 20TH St
Suite 5RW
New York, NY 10003-1310
Phone
(347) 665-7699
NPI assigned
Nov 5, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 5, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Acupuncturist 171100000X 25-003224 NY Primary

Addresses

Primary practice location

30 E 20TH St
Suite 5RW
New York, NY 10003-1310

Mailing address

3618 21St Ave
Astoria, NY 11105-1939
Phone (347) 665-7699

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
25-003224NYMDAcupuncturist

NPI Registry JSON

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

{
    "created_epoch": "1194220800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1194220800000",
    "number": "1982884151",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3618 21ST AVE",
            "city": "ASTORIA",
            "state": "NY",
            "postal_code": "111051939",
            "telephone_number": "347-665-7699"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "30 E 20TH ST",
            "address_2": "SUITE 5RW",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100031310",
            "telephone_number": "347-665-7699"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PULSIFER",
        "first_name": "JEREMY",
        "middle_name": "VARNUM",
        "name_prefix": "Mr.",
        "credential": "M.S.T.O.M., L.AC.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-11-05",
        "last_updated": "2007-11-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "171100000X",
            "taxonomy_group": "",
            "desc": "Acupuncturist",
            "state": "NY",
            "license": "25-003224",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 5, 2007; 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.