Active NPI
Cosman Camilo Mandujano Bejarano
- Surgery Physician
- Bronx, NY
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Surgery Physician
- License
- 312812
- Practice address
- 111 E 210TH St
Bronx, NY 10467-2401 - Phone
- (832) 675-0676
- NPI assigned
- Jun 19, 2015
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Surgery Physician | 208600000X | 312812 | NY | Primary |
Addresses
Primary practice location
111 E 210TH St
Bronx, NY 10467-2401
Mailing address
330 Cedar Street,Ynhh, Department of Surgery
New Haven, CT 06520
Phone (832) 675-0676
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in NY
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- General Surgery
- Education
- Other, 2012
- Medicare assignment
- May accept Medicare assignment
- Group practices
Practice addresses (Care Compare)
111 E 210TH St
Bronx, NY 10467-2401
Phone (866) 633-8255
3400 Bainbridge Ave
Bronx, NY 10467-2404
Phone (914) 378-6148
Hospital & facility affiliations
Merit-based Incentive Payment System (MIPS)
- Final score
- 100 of 100
- Promoting interoperability
- 100
- Improvement activities
- 40
Procedures performed for Medicare patients
| Procedure | Number of procedures |
|---|---|
| Colonoscopy | 1-10 |
| Hernia repair - groin (open) | 1-10 |
| Hernia repair (minimally invasive) | 1-10 |
| Upper gastrointestinal (GI) endoscopy for acid reflux | 1-10 |
| Removal of tissue | 1-10 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 312812 | NY | MD | Surgery Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Montefiore Medical Center | Surgery | Current | Accepting new patients |
| Montefiore Medical Center | Current | Accepting new patients | |
| Montefiore Mount Vernon Hospital | Past | Accepting new patients |
Locations
111 E 210th St
Bronx, NY 10467
1250 Waters Pl
Bronx, NY 10461
Phone (718) 409-9444
1825 Eastchester Rd
Bronx, NY 10461
Phone (718) 904-2000
600 E 233rd St
Bronx, NY 10466
Phone (718) 920-1640
128 Ashford Ave
Dobbs Ferry, NY 10522
Phone (914) 245-8936
100 Corporate Dr
Ste 100
Yonkers, NY 10701
Phone (914) 378-6148
1088 N Broadway
Yonkers, NY 10701
Phone (914) 964-4965
967 N Broadway
Yonkers, NY 10701
Phone (914) 798-8956
Networks
- Healthfirst Medicare Network H3359
- Healthfirst Medicare Network H5989
- Healthfirst Medicare Network H9678
- Healthfirst Medicare Network H1722
Interoperability endpoints
- cmanduja@montefioredirect.com
Organizations & group practices 3
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- Community/Retail Pharmacy
- Bronx, NY
- NPI 1194183715
-
- General Acute Care Hospital
- Mount Vernon, NY
- NPI 1013345065
Hospital & facility affiliations 2
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- General Acute Care Hospital
- Bronx, NY
- NPI 1952476988
-
- General Acute Care Hospital
- Yonkers, NY
- NPI 1578526695
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1434672000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1701388800000",
"number": "1013399666",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "330 CEDAR STREET,YNHH, DEPARTMENT OF SURGERY",
"city": "NEW HAVEN",
"state": "CT",
"postal_code": "06520",
"telephone_number": "832-675-0676"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "111 E 210TH ST",
"city": "BRONX",
"state": "NY",
"postal_code": "104672401",
"telephone_number": "832-675-0676"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MANDUJANO BEJARANO",
"first_name": "COSMAN",
"middle_name": "CAMILO",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2015-06-19",
"last_updated": "2023-12-01",
"certification_date": "2023-12-01",
"status": "A"
},
"taxonomies": [
{
"code": "208600000X",
"taxonomy_group": "",
"desc": "Surgery",
"state": "NY",
"license": "312812",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Bronx, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 1, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.