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BESPOKE SURGICAL, PC
NPI 1063733863
Surgery in New York, NY

Active since June 15, 2010CLIA Certified · 2 labs
160 7TH AVE S, NEW YORK, NY 10014(212) 206-1501(888) 880-8621 Get Directions Write a Review

NPPES record last updated: December 11, 2013. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Bespoke Surgical, Pc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

BESPOKE SURGICAL, PC (NPI 1063733863) is a healthcare organization registered as a surgery in New York, New York and active in the NPI registry since June 2010. The organization holds 2 active CLIA laboratory certificates and lists Evan Brad Goldstein, Owner, as its authorized official.

NPPES Registry Identity

NPI1063733863
Entity TypeOrganization
Primary Taxonomy208600000X
Legal Business NameBESPOKE SURGICAL, PC
Location Address160 7TH AVE SNew York, NY 10014-2727
Mailing Address160 7th Ave SNew York, NY 10014-2727 · (212) 206-1501 · Fax (888) 880-8621
Phone(212) 206-1501
Fax(888) 880-8621
Organization SubpartNo
Authorized OfficialEvan Brad GoldsteinOwner · (917) 570-4437
Enumeration DateJune 15, 2010
Last NPPES UpdateDecember 11, 2013
✔ NPI 1063733863 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtySurgeryAllopathic & Osteopathic Physicians
Taxonomy Code208600000X
Definition
A general surgeon has expertise related to the diagnosis - preoperative, operative and postoperative management - and management of complications of surgical conditions in the following areas: alimentary tract; abdomen; breast, skin and soft tissue; endocrine system; head and neck surgery; pediatric surgery; surgical critical care; surgical oncology; trauma and burns; and vascular surgery. General surgeons increasingly provide care through the use of minimally invasive and endoscopic techniques. Many general surgeons also possess expertise in transplantation surgery, plastic surgery and cardiothoracic surgery.
Also ListedPathology · Anatomic Pathology & Clinical PathologyTaxonomy 207ZP0102X
160 7TH AVE S, New York, NY 10014
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Other Identifiers 1

Medicare PINA100038046NY

Group Practice 1

Group TaxonomyThis provider is a business group of one or more individual practitioners, who practice with different areas of specialization.193200000X MULTI-SPECIALTY GROUP

CLIA Laboratory Certificates CMS CLIA 2

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Compliance 33D2092569

Bespoke Surgical PC · New York, NY
Active · expires Jan 11, 2028
CLIA Number33D2092569
Laboratory TypePhysician Office
Certificate Effective DateJanuary 12, 2026
Certificate Expiration DateJanuary 11, 2028
Laboratory DirectorDr. Jia Qin
Laboratory Phone(212) 206-1501
Laboratory LocationBespoke Surgical PC44 East 12th Street, Suite MD 1, New York, NY 10003
CLIA data matches this NPI record on: Name Phone
This certificate is issued to a laboratory after an inspection that finds the laboratory to be in compliance with all applicable CLIA requirements.

Certificate of Compliance 33D2068677

Bespoke Surgical PC · New York, NY
Active · expires Mar 26, 2027
CLIA Number33D2068677
Laboratory TypeIndependent
Certificate Effective DateAugust 22, 2014
Certificate Expiration DateMarch 26, 2027
Laboratory DirectorDr. Jia Qin
Laboratory Phone(212) 206-1501
Laboratory LocationBespoke Surgical PC44 East 12th Street, Suite MD 2, New York, NY 10014
CLIA data matches this NPI record on: Name Phone
This certificate is issued to a laboratory after an inspection that finds the laboratory to be in compliance with all applicable CLIA requirements.

Other Providers at the Same Location NPPES 2

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

SHADYA AKLE RWP
Nutritionist
160 7TH AVE S
NEW YORK, NY 10014
New York County (713) 992-9404
ONE SURGICAL
Surgery
160 7TH AVE S
NEW YORK, NY 10014
New York County (212) 206-1501

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Bespoke Surgical, PC's NPI number?

The NPI number for Bespoke Surgical, PC is 1063733863. It was assigned to this organization in the NPPES registry on June 15, 2010.

Where is Bespoke Surgical, PC located?

Bespoke Surgical, PC is located at 160 7th Ave S, New York, NY 10014. The listed phone number is (212) 206-1501.

What is Bespoke Surgical, PC's specialty?

The primary specialty registered for this NPI is Surgery with taxonomy code 208600000X.

Does Bespoke Surgical, PC hold CLIA laboratory certificates?

Yes. 2 active CLIA laboratory certificates are associated with this NPI under the federal Clinical Laboratory Improvement Amendments program. The certificates are listed in the CLIA Laboratory Certificates section above.

When was this NPI record last updated?

The NPPES record for Bespoke Surgical, PC was last updated on December 11, 2013. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 12 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.