NPIMap

Organization Active NPI

Montefiore Mount Vernon Hospital

  • General Acute Care Hospital
  • Mount Vernon, NY
National Provider Identifier
1013345065
Registry record updated Dec 23, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Acute Care HospitalTaxonomy code 282N00000X
Legal business name
MONTEFIORE MOUNT VERNON HOSPITAL
Practice address
12 N 7TH Ave
Mount Vernon, NY 10550-2026
Phone
(914) 664-8000
NPI assigned
Oct 29, 2013
Last updated
Dec 23, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 23, 2024

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
John M Preolo
Title
Senior Director Credentialing
Phone
(914) 608-5063

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Mental Health Clinic/Center 261QM0850X
General Acute Care Hospital 282N00000X Primary

Addresses

Primary practice location

12 N 7TH Ave
Mount Vernon, NY 10550-2026

Mailing address

12 N 7TH Ave
Mount Vernon, NY 10550-2026
Phone (914) 664-8000

Other practice location 1

100 Corporate Dr
Provider Information
Yonkers, NY 10701-6807
Phone (914) 377-4722

Other practice location 2

3 S 6th Ave
Mount Vernon, NY 10550-3197
Phone (914) 361-6239

Other names 2

  • Montefiore Mount Vernon Hospital Other name
  • Montefiore Mount Vernon Professional Billing Other name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY2 enrollments
Opioid treatment program
Medicare-enrolled since Feb 7, 2021

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20150423000849 NY Part B Supplier - Clinic/Group Practice 7810122231 Receives reassigned benefits from 145 practitioners
Practice locations: Mount Vernon, NY
O20230707002831 NY Part B Supplier - Opioid Treatment Program (Otp) 7810122231 Practice locations: Mount Vernon, NY

Other NPIs with the same Medicare PAC ID 1

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

National Provider Directory

National Provider Directory

Locations

1500 Blondell Ave
Bronx, NY 10461
Phone (718) 405-8410

100 Stevens Ave
Fl 7
Mount Vernon, NY 10550
Phone (914) 668-6366

175 Memorial Hwy
Ste 3-1
New Rochelle, NY 10801
Phone (914) 235-2387

Practitioners & affiliated clinicians

Practitioners 739

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 739

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1383004800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1734912000000",
    "number": "1013345065",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12 N 7TH AVE",
            "city": "MOUNT VERNON",
            "state": "NY",
            "postal_code": "105502026",
            "telephone_number": "914-664-8000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12 N 7TH AVE",
            "city": "MOUNT VERNON",
            "state": "NY",
            "postal_code": "105502026",
            "telephone_number": "914-664-8000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "100 Corporate Dr",
            "address_2": "Provider Information",
            "address_purpose": "LOCATION",
            "city": "Yonkers",
            "state": "NY",
            "postal_code": "107016807",
            "country_code": "US",
            "telephone_number": "914-377-4722",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "3 S 6th Ave",
            "address_purpose": "LOCATION",
            "city": "Mount Vernon",
            "state": "NY",
            "postal_code": "105503197",
            "country_code": "US",
            "telephone_number": "914-361-6239",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "MONTEFIORE MOUNT VERNON HOSPITAL",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-10-29",
        "last_updated": "2024-12-23",
        "certification_date": "2024-12-23",
        "status": "A",
        "authorized_official_last_name": "PREOLO",
        "authorized_official_first_name": "JOHN",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "SENIOR DIRECTOR CREDENTIALING",
        "authorized_official_telephone_number": "914-608-5063"
    },
    "taxonomies": [
        {
            "code": "261QM0850X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adult Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "282N00000X",
            "taxonomy_group": "",
            "desc": "General Acute Care Hospital",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Montefiore Mount Vernon Hospital",
            "code": "5",
            "type": "Other Name"
        },
        {
            "organization_name": "Montefiore Mount Vernon Professional Billing",
            "code": "5",
            "type": "Other Name"
        },
        {
            "organization_name": "Montefiore Mount Vernon Professional Billing",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Mount Vernon, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 23, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.