Individual provider Active NPI

Walter M Ralph Jr., M.D.

  • Otolaryngology Physician
  • Bronx, NY
National Provider Identifier
1013983097
Registry record updated Apr 9, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Otolaryngology PhysicianTaxonomy code 207Y00000X
License
223414 Issued in NY
Practice address
1650 Grand Concourse
Bronx, NY 10457-7606
Phone
(718) 901-6901
NPI assigned
Feb 28, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 9, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Otolaryngology Physician 207Y00000X 223414 NY Primary

Addresses

Primary practice location

1650 Grand Concourse
Bronx, NY 10457-7606

Mailing address

1650 Grand Concourse
Bronx, NY 10457-7606
Phone (718) 518-5033

Other identifiers 3

IdentifierTypeStateIssuer
P2686068OtherNYOXFORD
02348552MedicaidNY
6M8142OtherNYBCBS

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
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040412000549 NY Practitioner - OtolaryngologyPractitioner - Internal Medicine 2163416348 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
OtolaryngologyAlso: Internal Medicine
Education
Harvard Medical School, 1995
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Bronxcare Health SystemGroup PAC ID 3870404429, 335 clinicians

Practice addresses (Care Compare)

1650 Grand Concourse
Bronx, NY 10457-7606
Phone (718) 992-7669

Hospital & facility affiliations

  • Bronxcare Hospital Center Hospital, Bronx, NY, CCN 330009

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Bronxcare Health System CurrentSince Oct 1, 2015 Accepting new patients
Morris Heights Health Center, Inc. CurrentSince Aug 29, 2011 Accepting new patients
Morris Heights Health Center, Inc. Otolaryngology CurrentSince Aug 29, 2011 Accepting new patients
Bronxcare Health System Otolaryngology CurrentSince Oct 1, 2015 Accepting new patients
Bronxcare Dr. Martin Luther King Jr. Health Center Otolaryngology Past Accepting new patients
Bronxcare Health System Past Accepting new patients
North Shore-Lij Medical PC Otolaryngology Past Accepting new patients

Locations

1650 Grand Concourse
Fl 6
Bronx, NY 10457
Phone (718) 901-6901

1650 Grand Concourse
Bronx, NY 10457
Phone (718) 294-7104

1265 Franklin Ave
Bronx, NY 10456
Phone (718) 503-7700

85 W Burnside Ave
Bronx, NY 10453
Phone (718) 483-1270

Networks

  • Healthfirst Medicare Network H9678
  • Healthfirst Medicare Network H3359
  • Healthfirst Medicare Network H1722
  • Healthfirst Medicare Network H5989

Organizations & group practices 7

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.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1141084800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1428537600000",
    "number": "1013983097",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1650 GRAND CONCOURSE",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "104577606",
            "telephone_number": "718-518-5033"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1650 GRAND CONCOURSE",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "104577606",
            "telephone_number": "718-901-6901"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RALPH",
        "first_name": "WALTER",
        "middle_name": "M",
        "name_suffix": "Jr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-02-28",
        "last_updated": "2015-04-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Y00000X",
            "taxonomy_group": "",
            "desc": "Otolaryngology",
            "state": "NY",
            "license": "223414",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OXFORD",
            "identifier": "P2686068",
            "state": "NY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02348552",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "6M8142",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Bronx, NY

Sources for this page

Verify at the official NPI Registry.