FAMILY MEDICINE ASSOCIATES OF ITHACA (NPI# 1376950352) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1376950352 |
| Entity Type | Organization |
| Organization Name | FAMILY MEDICINE ASSOCIATES OF ITHACA |
| Other Organization Name | FAMILY MEDICINE ASSOCIATES- BRENTWOOD |
| Practice Address |
8 Brentwood Dr Ithaca NY 14850-1871 |
| Mailing Address |
9276 Scranton Rd Suite 100 San Diego CA 92121-7701 |
| Practice Telephone | 6072774341 |
| Enumeration Date | 2014-07-22 |
| Last Update Date | 2016-01-04 |
| Authorized Official Name | KENNY HEINE (VP OF OPERATIONS) |
| Authorized Official Telephone | 8589641506 |
| Is Organization Subpart | Y |
| Parent Organization Name | MEDVANTX, INC |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 332900000X | Non-Pharmacy Dispensing Site | 126988 | NY | Suppliers |
| Other Name | Type Code |
|---|---|
| Family Medicine Associates- Brentwood | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1013324318 | Family Medicine Associates of Ithaca | Non-Pharmacy Dispensing Site | 209 W State St, Ithaca, NY 14850-5429 | 2014-07-18 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| New York State Corporations | FAMILY MEDICINE ASSOCIATES OF ITHACA, LLP | 209 West State Street, Ithaca, Ny 14850 |
| Street Address |
8 BRENTWOOD DR |
| City | ITHACA |
| State | NY |
| Zip Code | 14850-1871 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1114929312 | Susan R Cowdery | Psychiatry & Neurology | 8 Brentwood Dr, Suite B, Ithaca, NY 14850-1871 | 2005-06-01 |
| 1598289993 | Nicole Ann Serrano | Nurse Practitioner | 8 Brentwood Dr, Ithaca, NY 14850-1871 | 2017-07-28 |
| 1942617915 | Cayuga Medical Associates, Inc. | Clinical Nurse Specialist | 8 Brentwood Dr, Ithaca, NY 14850-1871 | 2014-07-22 |
| 1780826198 | Deana Bonno | Psychiatry & Neurology | 8 Brentwood Dr, Ithaca, NY 14850-1871 | 2009-03-31 |
| 1508811316 | Linda Radomski | Internal Medicine | 8 Brentwood Dr, Suite B, Ithaca, NY 14850-1863 | 2006-05-23 |
| 1477505279 | Serena H. Yoon | Internal Medicine | 8 Brentwood Dr, Suite B, Ithaca, NY 14850-1863 | 2006-05-17 |
| 1609877158 | Michael Slattery | Psychiatry & Neurology | 8 Brentwood Dr, Ithaca, NY 14850-1871 | 2005-08-09 |
| 1457353666 | Jody M Stackman | Psychiatry & Neurology | 8 Brentwood Dr, Suite B, Ithaca, NY 14850-1871 | 2005-06-01 |
| 1316949522 | James S Gaffney | Psychiatry & Neurology | 8 Brentwood Dr, Suite B, Ithaca, NY 14850-1871 | 2005-06-01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1174123897 | Michelle Lee Sanito | Registered Nurse | 400 Lake Street, Ithaca, NY 14850 | 2020-10-30 |
| 1457959843 | Summit Alternatives Lmsw PC | Community/Behavioral Health | 215 North Cayuga Street, 2nd Floor Business Complex, Ithaca, NY 14850 | 2020-10-16 |
| 1518581701 | Sameer Acharya | Student in an Organized Health Care Education/Training Program | Internal Medicine Residency, Cayuga Medical Center, 101 Dates Drive, Ithaca, NY 14850 | 2020-06-03 |
| 1699399873 | Anurag Aryal | Student in an Organized Health Care Education/Training Program | 101 Dates Drive Internal Medicine Residency, Cayuga Med, Ithaca, NY 14850 | 2020-06-03 |
| 1932723228 | Binay Kumar Kshetree | Student in an Organized Health Care Education/Training Program | Cayuga Medical Center, 101 Dates Drive, Ithaca, NY 14850 | 2020-06-02 |
| 1225657349 | Nima Hazrati Pour Fard | Student in an Organized Health Care Education/Training Program | Internal Medicine Residency Cayuga Medical Center, 101, Ithaca, NY 14850 | 2020-04-09 |
| 1326671090 | Garret Hoskey | Specialist/Technologist | 953 Dany Road, Ithaca, NY 14850 | 2020-02-20 |
| 1609407709 | En-ting Hsu | Marriage & Family Therapist | 110 N. Cayuga Street 4th Floor Suite 3, Ithaca, NY 14850 | 2020-01-28 |
| 1306491063 | Patrick Owen Mckeon | Specialist/Technologist | Hill Center G66, 953 South Danby Rd., Ithaca, NY 14850 | 2019-08-08 |
| 1538722343 | Priyesh Thakurathi | Student in an Organized Health Care Education/Training Program | 101 Dates Drive Cayuga Medical Center, Internal Medicine Residency Program, Ithaca, NY 14850 | 2019-04-17 |
| Find all providers in zip 14850 | ||||
| Taxonomy Code | 332900000X |
| Grouping | Suppliers |
| Classification | Non-Pharmacy Dispensing Site |
| A site other than a pharmacy that dispenses medicinal preparations under the supervision of a physician to patients for self-administration. (e.g. physician offices, ER, Urgent Care Centers, Rural Health Facilities, etc.) |
| Notes: Source: Developed by National Council for Prescription Drug Programs (NCPDP), National Home Infusion Association (NHIA), and Pharmacist Services Technical Advisory Coalition (PSTAC) [1/1/2006: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1013324318 | Family Medicine Associates of Ithaca | Non-Pharmacy Dispensing Site | 209 W State St, Ithaca, NY 14850-5429 | 2014-07-18 |
| 1144635087 | Ann R Costello | Non-Pharmacy Dispensing Site | 217 N Aurora St, Suite 2, Ithaca, NY 14850-4345 | 2014-06-30 |
| 1881761484 | Planned Parenthood of The Southern Finger Lakes Inc. | Non-Pharmacy Dispensing Site | 620 W Seneca St, Ithaca, NY 14850-3326 | 2006-11-29 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1962041426 | B & R Wholesale, LLC | Non-Pharmacy Dispensing Site | 3858 Nostrand Ave Ste 203, Brooklyn, NY 11235-2038 | 2020-01-02 |
| 1508417221 | Eyeconic Vision Brownsville Inc | Non-Pharmacy Dispensing Site | 9617 Church Ave, Brooklyn, NY 11212-2443 | 2019-09-24 |
| 1588180343 | Incubizness, Inc. | Non-Pharmacy Dispensing Site | 717 Church St, Medina, NY 14103-1618 | 2017-08-14 |
| 1649722976 | Eyeconic Vision Group Inc | Non-Pharmacy Dispensing Site | 248 W 116th St, New York, NY 10026-2406 | 2016-11-03 |
| 1134585292 | Applied Sciences Edi Corp | Non-Pharmacy Dispensing Site | 3825 Bell Blvd, Bayside, NY 11361-3368 | 2016-01-05 |
| 1790168656 | Otc Mobile Stores | Non-Pharmacy Dispensing Site | 600 E 132nd St, Bronx, NY 10454-4639 | 2015-07-09 |
| 1235520271 | Allied Medical and Diagnostic Services, Dispensary | Non-Pharmacy Dispensing Site | 1410 Broadway, 23rd Floor, New York, NY 10018 | 2015-02-12 |
| 1083012348 | Add 2 Subtract LLC | Non-Pharmacy Dispensing Site | 22 Legendary Cir, Rye Brook, NY 10573-1077 | 2014-12-18 |
| 1912302233 | Performance Medical Services Pllc | Non-Pharmacy Dispensing Site | 70 E 55th St, 2nd Fl., New York, NY 10022-3222 | 2014-10-29 |
| 1346568730 | Hero Direct Inc | Non-Pharmacy Dispensing Site | 889 Waverly Ave, Holtsville, NY 11742-1109 | 2010-05-10 |
| Find all providers with the same taxonomy | ||||
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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.