67TH STREET OB GYN PLLC — NPI 1306217971 (Board-Certified Obstetrician & Gynecologist (Women's Health & Pregnancy Doctor) in NEW YORK, NY)

CMS-1500 Box 24J / 33a • NPI

1306217971

Type 2 Organization (Box 32a/33a)

HIPAA NUCC Taxonomy • CMS Code

207V00000X (CMS 16)

Board-Certified Obstetrician & Gynecologist (Women's Health & Pregnancy Doctor)

Box 32 Service Location & ZIP+4

115 E 67TH ST APT 1A, NEW YORK, NY, 10065-5990

✓ 9-Digit EDI 837 ZIP+4 (10065-5990)

Practice Phone & Referral Fax

(212) 249-3949

Fax: (312) 602-9799

✓ HHS OIG LEIE Sanction Screening — VERIFIED CLEAR: NPI 1306217971 (67TH STREET OB GYN PLLC) has 0 active federal exclusions across all 84,224 HHS OIG LEIE sanction records (Database Verified: 2026-11-11).

CMS Medicare Order & Referring PECOS Eligibility

Institutional Type-2 NPI facilities enroll via CMS-855A institutional provider agreements rather than individual Order & Referring PECOS.

Official CMS NPPES Credential & Practice Profile

10-Digit NPI Number	`1306217971` (NPI-2 Organization / Facility)
Provider / Legal Name	67TH STREET OB GYN PLLC
Plain-English Specialty	Board-Certified Obstetrician & Gynecologist (Women's Health & Pregnancy Doctor) NUCC Code: `207V00000X` (Obstetrics & Gynecology)
Certifying / Licensing Body	American Board of Obstetrics and Gynecology (ABOG)
Practice Location Address	115 E 67TH ST APT 1A, NEW YORK, NY, 10065-5990
Practice Telephone / Fax	Tel: (212) 249-3949 \| Fax: (312) 602-9799
Administrative Mailing Address	PO BOX 645990, CINCINNATI, OH, 45264-5990
Enumeration & Last Sync	Enumerated: 2015-10-08 \| CMS Record Updated: 2023-03-01
Authorized Official	DANIEL ROSHAN (MD)

Clinic Location, Accessibility & Directions

📍 Practice Location & Patient Access

115 E 67TH ST APT 1A, NEW YORK, NY, 10065-5990

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Plain-English Taxonomy & CMS Crosswalk (207V00000X)

What Does Taxonomy Code 207V00000X Mean?

In the HIPAA National Uniform Claim Committee (NUCC) classification, code 207V00000X translates to:
"Board-Certified Obstetrician & Gynecologist (Women's Health & Pregnancy Doctor)"

CMS-1500 Medicare Specialty Crosswalk: CMS Code 16 (Physician/Obstetrics & Gynecology)
Certifying / Accrediting Authority: American Board of Obstetrics and Gynecology (ABOG)
Clinical Scope: Pregnancy confirmation and prenatal care, Pap smears and HPV vaccination, menstrual irregularities, pelvic pain, PCOS, or menopause management.

Specialty Clinical Procedures & Therapeutic Classes

Standard Scope of Care (67TH STREET OB GYN PLLC)

Typical CPT / Diagnostic Procedures:

Comprehensive Antenatal Care, Fetal Ultrasound & Labor/Delivery
Cervical Cytology (Pap Smear), HPV Co-Testing & Colposcopy
Pelvic Ultrasound & Minimally Invasive Laparoscopic Hysterectomy/Myomectomy

Common Therapeutic Classes:

Prenatal Folic Acid, Iron & Progesterone Supplementation
Combined Oral Contraceptives, Levonorgestrel IUDs & Hormone Therapy
Fluconazole, Metronidazole & Pregnancy-Safe Beta-Lactam Antibiotics (Ampicillin)

All Registered NUCC Taxonomies & State Licenses

Taxonomy Code & Plain-English Description	State License & Primary Status
`207V00000X` — Obstetrics & Gynecology Plain English: Board-Certified Obstetrician & Gynecologist (Women's Health & Pregnancy Doctor)	State: N/A \| License: `Verified` \| Primary: Yes (Primary)

Medical Billing, RCM & Hospital Credentialing Teams:

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67TH STREET OB GYN PLLC (NPI #1306217971)