PROVIDENT HEALTH PARTNERS INC. (NPI# 1275157000) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1275157000 |
| Entity Type | Organization |
| Organization Name | PROVIDENT HEALTH PARTNERS INC. |
| Practice Address |
1529 N Ocean Ave Ste A Medford NY 11763-3587 |
| Mailing Address |
554 Larkfield Rd Ste 207 East Northport NY 11731-4205 |
| Practice Telephone | 6312664501 |
| Practice Fax Number | 6312664502 |
| Mailing Telephone | 6312664501 |
| Mailing Fax Number | 6312664502 |
| Enumeration Date | 2020-06-08 |
| Last Update Date | 2020-06-08 |
| Authorized Official Name | JENNIFER DESOUSA (ADMINISTRATOR) |
| Authorized Official Telephone | 6312664501 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261Q00000X | Clinic/Center | Ambulatory Health Care Facilities |
| Street Address |
1529 N OCEAN AVE STE A |
| City | MEDFORD |
| State | NY |
| Zip Code | 11763-3587 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1316572027 | Rebecca Molino | Specialist | 9, 3251 Ny-112 #2, Medford, NY 11763 | 2020-03-03 |
| 1295203677 | Hajar Taman | Pharmacist | 2975 Horseblock Road, Medford, NY 11763 | 2018-11-05 |
| 1265917041 | Bay Taxi Inc | Taxi | 36/94 Horseblock Rd, Medford, NY 11763 | 2018-09-27 |
| 1184108383 | Bay Taxi Inc | Taxi | 36/94 Horsblock Road, Medford, NY 11763 | 2018-09-24 |
| 1215419650 | Megan Bell | Speech-Language Pathologist | 135 Buffalo Avenue, Medford, NY 11763 | 2018-09-01 |
| 1922592906 | Elizabeth L Oakley | Specialist | 1 Sprat St, Medford, NY 11763 | 2018-06-21 |
| 1609383389 | Federation of Organizations for The New York State Mentally Disabled | Clinic/Center | 3390 Route 112 Ste B, Medford, NY 11763 | 2018-01-04 |
| 1497109607 | Tabitha Aitken | Massage Therapist | 28 Masem Ct, Medford, NY 11763 | 2016-04-14 |
| 1518326685 | Betty Velez | Specialist | 21 Red Pine Rd, Medford, NY 11763 | 2016-02-18 |
| 1134527054 | Angelo L D'esposito | Social Worker | 77 Robinson Ave, Medford, NY 11763 | 2014-12-09 |
| Find all providers in zip 11763 | ||||
| Taxonomy Code | 261Q00000X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| A facility or distinct part of one used for the diagnosis and treatment of outpatients. "Clinic/Center" is irregularly defined, sometimes being limited to organizations serving specialized treatment requirements or distinct patient/client groups (e.g., radiology, poor, and public health). |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1427680057 | Ortc, LLC | Clinic/Center | 750 Biddle Rd Ste 102, Medford, OR 97504-6178 | 2020-02-11 |
| 1528543949 | Planned Parenthood of Southwestern Oregon | Clinic/Center | 125 S Central Ave Ste 201, Medford, OR 97501-7222 | 2018-10-02 |
| 1417438359 | Ideal Option, Pllc | Clinic/Center | 216 E Main St Ste 201, Medford, OR 97501-6029 | 2018-08-28 |
| 1750828778 | Regis College | Clinic/Center | 50 Dexter St, 1, Medford, MA 02155-6668 | 2017-01-28 |
| 1629428248 | Southern Oregon Denture & Dental | Clinic/Center | 41 Hawthorne St, Medford, OR 97504-7113 | 2016-06-14 |
| 1881021715 | Oregon Health Sciences University | Clinic/Center | 3192 Arnold Palmer Way, Medford, OR 97504-7773 | 2013-10-10 |
| 1023372067 | Riverside Chiropractic Wellness Centers, Inc | Clinic/Center | 65 Riverside Ave Ste C, Medford, MA 02155-4653 | 2012-06-25 |
| 1497051320 | Northwest Diagnostic Services | Clinic/Center | 2728 W Main St, Suite 121, Medford, OR 97501-2499 | 2011-02-10 |
| 1265745541 | Oregon Internal Medicine, LLC. | Clinic/Center | 2380 W Main St, Suite, A, Medford, OR 97501-2390 | 2010-07-15 |
| 1639209117 | Planned Parenthood of Southwestern Oregon | Clinic/Center | 125 S Central Ave, Suite 201, Medford, OR 97501-7205 | 2007-03-06 |
| Find all providers in MEDFORD | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.