NPIMap

Organization Active NPI

Mount Sinai School of Medicine

  • Hematology & Oncology Physician
  • Rockville Centre, NY
National Provider Identifier
1013484039
Registry record updated Jan 11, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Hematology & Oncology PhysicianTaxonomy code 207RH0003X
Legal business name
MOUNT SINAI SCHOOL OF MEDICINE
Practice address
242 Merrick Rd Ste 301
Rockville Centre, NY 11570-5254
Phone
(516) 536-1455
NPI assigned
Oct 29, 2018
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 11, 2019

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

Authorized official

Name
Alicia Gresham
Title
VP Network Operations
Phone
(212) 659-9038

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Hematology & Oncology PhysicianGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 207RH0003X Primary
Medical Oncology PhysicianGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 207RX0202X
Oncology Clinical Nurse SpecialistGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 364SX0200X

Addresses

Primary practice location

242 Merrick Rd Ste 301
Rockville Centre, NY 11570-5254

Mailing address

242 Merrick Rd Ste 301
Rockville Centre, NY 11570-5254
Phone (516) 536-1455

Other names 1

  • Mount Sinai Marathon Medical - Oncology Other name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20130712000368 NY Part B Supplier - Clinic/Group Practice 6406096544 Receives reassigned benefits from 385 practitioners
15 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Lynbrook, NY; Long Beach, NY; Manhasset, NY; Merrick, NY; New York, NY; Oceanside, NY; Rockville Centre, NY; Valley Stream, NY…

Other NPIs on the same Medicare enrollment 15

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

View all 15

National Provider Directory

National Provider Directory

Locations

150 E 42nd St
Frnt A
New York, NY 10017

Practitioners & affiliated clinicians

Practitioners 19

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

View all 19

NPI Registry JSON

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

{
    "created_epoch": "1540771200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1547164800000",
    "number": "1013484039",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "242 MERRICK RD STE 301",
            "city": "ROCKVILLE CENTRE",
            "state": "NY",
            "postal_code": "115705254",
            "telephone_number": "516-536-1455"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "242 MERRICK RD STE 301",
            "city": "ROCKVILLE CENTRE",
            "state": "NY",
            "postal_code": "115705254",
            "telephone_number": "516-536-1455"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MOUNT SINAI SCHOOL OF MEDICINE",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-10-29",
        "last_updated": "2019-01-11",
        "status": "A",
        "authorized_official_last_name": "GRESHAM",
        "authorized_official_first_name": "ALICIA",
        "authorized_official_title_or_position": "VP NETWORK OPERATIONS",
        "authorized_official_telephone_number": "212-659-9038"
    },
    "taxonomies": [
        {
            "code": "207RH0003X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Internal Medicine, Hematology & Oncology",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "207RX0202X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Internal Medicine, Medical Oncology",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "364SX0200X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Clinical Nurse Specialist, Oncology",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Mount Sinai Marathon Medical - Oncology",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Rockville Centre, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 11, 2019; 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.