PORT CITY EMERGENCY PHYSICIANS LLP (NPI# 1134370547) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1134370547 |
| Entity Type | Organization |
| Organization Name | PORT CITY EMERGENCY PHYSICIANS LLP |
| Practice Address |
110 W 6th St Oswego NY 13126-2507 |
| Mailing Address |
75 Remit Drive # 6151 Chicago IL 60675-6151 |
| Practice Telephone | 3153495511 |
| Mailing Telephone | 8669165259 |
| Mailing Fax Number | 2319224030 |
| Enumeration Date | 2008-10-03 |
| Last Update Date | 2009-07-01 |
| Authorized Official Name | DR. DERIK K KING (LLP, MANAGING PARTNER) |
| Authorized Official Telephone | 8669165259 |
| Authorized Official Credential | MD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207P00000X | Emergency Medicine | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| NY | 03070353 | 05 | |
| NY | BCBS | 204500949 | 01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1548402530 | Port City Emergency Physicians LLP | Emergency Medicine | 510 South Fourth Street, Fulton, NY 13069-2904 | 2009-04-06 |
| 1316395460 | Port City Emergency Physicians LLP | Emergency Medicine | 150 Broad St, Hamilton, NY 13346-9575 | 2016-05-31 |
| 1669721296 | Port City Emergency Physicians LLP | Emergency Medicine | 3045 East Ave, Central Square, NY 13036-9502 | 2012-08-29 |
| Street Address |
110 W 6TH ST |
| City | OSWEGO |
| State | NY |
| Zip Code | 13126-2507 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1821080334 | Ahmad Al-salameh | Pathology | 110 W 6th St, Oswego, NY 13126-2507 | 2005-08-19 |
| 1881205847 | Cynthia Lorraine Althouse | Nurse Practitioner | 110 W 6th St, Oswego, NY 13126-2507 | 2020-08-13 |
| 1629696224 | Ruth Noemi Vasquez | Nurse Practitioner | 110 W 6th St, Oswego, NY 13126-2507 | 2020-07-09 |
| 1750906608 | Gretchen Schlieder | Nurse Practitioner | 110 W 6th St, Oswego, NY 13126-2507 | 2020-06-16 |
| 1215552567 | Gretchen Ann Garland | Nurse Practitioner | 110 W 6th St, Oswego, NY 13126-2507 | 2020-06-12 |
| 1619508967 | Arthur Ezzo | Physical Therapy Assistant | 110 W 6th St, Oswego, NY 13126-2507 | 2020-01-27 |
| 1396381000 | Misty Putnam | Physician Assistant | 110 W 6th St, Oswego, NY 13126-2507 | 2019-11-18 |
| 1144880964 | Nathaniel Michael Farden | Nurse Practitioner | 110 W 6th St, Oswego, NY 13126-2507 | 2019-06-14 |
| 1497245922 | Rockaway Emergency Medicine Services PC | Physician Assistant | 110 W 6th St, Oswego, NY 13126-2507 | 2018-05-10 |
| 1134631740 | Rebecca Grethel | Hospitalist | 110 W 6th St, Oswego, NY 13126-2507 | 2017-11-05 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1992303572 | Elise Fitzsimmons | Specialist/Technologist | 9 Laker Hall, Oswego, NY 13126 | 2020-10-15 |
| 1023651742 | Jessica Lynn Metzger | Physician Assistant | 300 Ny-104 Suite 1, Oswego, NY 13126 | 2019-10-25 |
| 1245887009 | Maureen Adams | Technician | 30 Stone Ridge Drive, Oswego, NY 13126 | 2019-08-26 |
| 1285128314 | Justin Raymond Beebe | Nurse Practitioner | 300 State Route 104 Ste 2, Oswego, NY 13126 | 2018-06-21 |
| 1801311220 | Lynne M Wallace | Registered Nurse | 29 Birch Lane 17b, Oswego, NY 13126 | 2017-08-07 |
| 1497203962 | Lindsay Cheslock | Local Education Agency (LEA) | 529 County Route 25, Oswego, NY 13126 | 2016-09-14 |
| 1942757919 | Aimee Devinny | Registered Nurse | 21 Twin Orchard Drive, Oswego, NY 13126 | 2016-09-07 |
| 1083160295 | Cameron Delmotte | Specialist | 159 West Frist Street, Oswego, NY 13126 | 2016-08-28 |
| 1508319187 | Samantha Thayer | Occupational Therapist | 159 West First Oswego St, Oswego, NY 13126 | 2016-07-29 |
| 1104279595 | Vikram Jala | Internal Medicine | 105 County Route 45a Ste 400, Oswego, NY 13126 | 2016-07-20 |
| Find all providers in zip 13126 | ||||
| Taxonomy Code | 207P00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Emergency Medicine |
| An emergency physician focuses on the immediate decision making and action necessary to prevent death or any further disability both in the pre-hospital setting by directing emergency medical technicians and in the emergency department. The emergency physician provides immediate recognition, evaluation, care, stabilization and disposition of a generally diversified population of adult and pediatric patients in response to acute illness and injury. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source; 7/1/2011: mofified source] - Additional Resources: American Board of Emergency Medicine, 2007. http://www.abem.org/public/; American Osteopathic Board of Emergency Medicine, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Emergency Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Emergency Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1184718801 | Bruce T Pecorella | Emergency Medicine | 110 West Sixth Street, Oswego, NY 13126 | 2006-10-03 |
| 1851704357 | Brendan Michael Rogers | Emergency Medicine | 110 W 6th St, Oswego, NY 13126-2598 | 2014-06-03 |
| 1013327741 | Rhonaldo Agung Silaban | Emergency Medicine | 110 W 6th St, Oswego, NY 13126-2507 | 2014-05-02 |
| 1336472182 | Brandon T Wolfenden | Emergency Medicine | 110 W 6th St, Oswego, NY 13126-2507 | 2009-09-11 |
| 1316175052 | Kevin T Le Roy | Emergency Medicine | 110 W 6th St, Oswego, NY 13126-2507 | 2009-07-01 |
| 1407033459 | Robert J. Glanz | Emergency Medicine | 110 W 6th St, Oswego, NY 13126-2507 | 2008-01-22 |
| 1902941156 | James David Sawyer | Emergency Medicine | 110 W 6th St, Oswego Hospital, Oswego, NY 13126-2507 | 2007-02-21 |
| 1659450989 | Douglas Paul Guenter | Emergency Medicine | 110 W Utica St, Oswego, NY 13126-3047 | 2006-11-06 |
| 1700809860 | Michael S Nupuf | Emergency Medicine | 110 W 6th St, Oswego, NY 13126-2507 | 2006-07-26 |
| 1144204488 | Cupid C Gascon | Emergency Medicine | 110 W 6th St, Oswego, NY 13126-2507 | 2005-11-30 |
| Find all providers in OSWEGO | ||||
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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.