SOUTHERN NEW YORK PRIMARY CARE SERVICES IPA, LLC (NPI# 1013302355) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1013302355 |
| Entity Type | Organization |
| Organization Name | SOUTHERN NEW YORK PRIMARY CARE SERVICES IPA, LLC |
| Practice Address |
1200 State Route 208 Monroe NY 10950-4648 |
| Mailing Address |
3113 Lawton Road Suite 250 Orlando FL 32803 |
| Practice Telephone | 8888298550 |
| Practice Fax Number | 8554189149 |
| Mailing Telephone | 8888298550 |
| Mailing Fax Number | 8554189149 |
| Enumeration Date | 2015-04-03 |
| Last Update Date | 2019-10-22 |
| Authorized Official Name | MR. BRETT KENEFICK (PRESIDENT) |
| Authorized Official Telephone | 8888298550 |
| Is Organization Subpart | Y |
| Parent Organization Name | VAXCARE CORPORATION |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207Q00000X | Family Medicine | 153414 | NY | Allopathic & Osteopathic Physicians |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| New York State Corporations | SOUTHERN NEW YORK PRIMARY CARE SERVICES IPA, LLC | 3113 Lawton Road Ste. 250, Orlando, Fl 32803 |
| Street Address |
1200 STATE ROUTE 208 |
| City | MONROE |
| State | NY |
| Zip Code | 10950-4648 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1083616486 | Barbara E Kura | Registered Nurse | 1200 State Route 208, Suite 13, Monroe, NY 10950-4648 | 2005-08-15 |
| 1306334552 | Physician Management Services of New York, LLC | Family Medicine | 1200 State Route 208, Monroe, NY 10950-4648 | 2018-04-24 |
| 1760925689 | Wendy Dawn Rodriguez | Nurse Practitioner | 1200 State Route 208, Suite 13, Monroe, NY 10950-4648 | 2016-11-25 |
| 1356665442 | James N Mcmonagle | Pharmacist | 1200 State Route 208, Suite 1, Monroe, NY 10950-4648 | 2010-03-18 |
| 1689998007 | Christine C Leoniak | Pharmacist | 1200 State Route 208, Suite 1, Monroe, NY 10950-4648 | 2010-03-15 |
| 1326362724 | John Mark Pietsch | Pharmacist | 1200 State Route 208, Suite#1, Monroe, NY 10950-4648 | 2010-03-15 |
| 1750605168 | Martin Teich | Pharmacist | 1200 State Route 208, Suite 1, Monroe, NY 10950-4648 | 2010-03-15 |
| 1083883458 | Exodushealth Medical, PC | Psychologist | 1200 State Route 208, Monroe, NY 10950-4648 | 2008-02-29 |
| 1669655502 | Xiomara D Quezada | Physician Assistant | 1200 State Route 208, Ste 13, Monroe, NY 10950-4648 | 2007-12-14 |
| 1891988853 | Madeleine Myers | Nurse Practitioner | 1200 State Route 208, Suite 13, Monroe, NY 10950-4648 | 2007-08-23 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1588202063 | Tova Schur | Physician Assistant | 2 Strelisk Court, Monroe, NY 10950 | 2019-12-16 |
| 1265947238 | Brenda Ayllene Sabatello | Specialist | 126 Barr Lne, Monroe, NY 10950 | 2017-12-12 |
| 1740719038 | Heartstrings LLC | Home Health | 6 Mountain Road, Unit 204, Monroe, NY 10950 | 2017-06-08 |
| 1841739752 | Committed Home Care Inc. | Home Health | 14 Fillmore Court Unit 311, Monroe, NY 10950 | 2017-02-13 |
| 1104362813 | Alison Guiney | Case Manager/Care Coordinator | 101 Stage Road, Monroe, NY 10950 | 2017-01-19 |
| 1710436332 | Elite Services Ny Inc. | Home Health | 48 Bakertown Road Suite 204, Monroe, NY 10950 | 2016-09-23 |
| 1780047084 | Stephanie Santiago | Occupational Therapy Assistant | 27 Sandra Ln, Monroe, NY 10950 | 2016-04-04 |
| 1851770440 | Priority Home Care Services, Inc. | Home Health | 48 Bakertown Road, Suite 204, Monroe, NY 10950 | 2015-05-28 |
| 1518344274 | Mydesh Inc | Pharmacy | 581 Nys Route 17m, Monroe, NY 10950 | 2015-05-01 |
| 1942694377 | Yenty Fischel | Occupational Therapist | 1 Diner Rd, Monroe, NY 10950 | 2015-03-24 |
| Find all providers in zip 10950 | ||||
| Taxonomy Code | 207Q00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Family Medicine |
| Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity. |
| Notes: Source: American Board of Family Medicine [1/1/2007: changed title; 7/1/2007: added definition, added source; 7/1/2017: modified definition] - Note: The American Osteopathic Board of Family Physicians certification includes extensive use of Osteopathic Manipulative Treatment (OMT), which integrates the biological, clinical, and behavioral sciences. - Additional Resources: American Board of Family Medicine, www.theabfm.org. American Osteopathic Board of Family Physicians, www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Family Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Family Physicians or the American Board of Family Medicine. |
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| 1972124832 | Jessica Womack | Family Medicine | 527 W Hurd Rd, Monroe, MI 48162-9205 | 2020-05-01 |
| 1134781412 | Joshua Dwaine Lentz | Family Medicine | Promedica Monroe Regional Hospital, 650 Stewart Road, Monroe, MI 48162 | 2019-07-08 |
| 1376000620 | Paladina Health, LLC | Family Medicine | Paladina Health Monroe Campus Park, 1640 A Campus Park Drive, Monroe, NC 28112 | 2019-02-22 |
| 1457822991 | Affinity Health Group, LLC | Family Medicine | 920 Oliver Rd Ste A2, Monroe, LA 71201-5702 | 2018-12-10 |
| 1144601121 | Rebecca Redding | Family Medicine | 924 W Spring St Ste A, Monroe, GA 30655-1751 | 2015-06-15 |
| 1285069088 | Geaux Family Health, LLC | Family Medicine | 2408 Duval Dr, Suite 1, Monroe, LA 71201-2986 | 2013-09-11 |
| 1033559844 | Mvhe, Inc | Family Medicine | 20 Overbrook Dr Ste C, Monroe, OH 45050-1147 | 2013-06-26 |
| 1982048237 | Erin Robinson Breard | Family Medicine | 3995 Sterlington Rd, Ste A, Monroe, LA 71203-3723 | 2013-04-17 |
| 1659614022 | Mercy Memorial Hospital Corporation | Family Medicine | 650 Steward Road, Monroe, MI 48162 | 2013-04-03 |
| 1598015968 | Urban Medical Clinic, Inc. | Family Medicine | 1910 Jackson St., Monroe, LA 71202-2532 | 2012-09-13 |
| Find all providers in MONROE | ||||
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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.