Individual provider Active NPI

Melissa Pittel Wasserstein, MD

  • Clinical Biochemical Genetics Physician
  • New York, NY
National Provider Identifier
1023066198
Registry record updated Apr 13, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Biochemical Genetics PhysicianTaxonomy code 207SG0202X
License
194048 Issued in NY
Practice address
1 Gustave L Levy PL
Box 1497
New York, NY 10029-6500
Phone
(212) 241-2478
NPI assigned
May 4, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 13, 2011

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Genetics (M.D.) Physician 207SG0201X 194048 NY
Clinical Biochemical Genetics Physician 207SG0202X 194048 NY Primary

Addresses

Primary practice location

1 Gustave L Levy PL
Box 1497
New York, NY 10029-6500

Mailing address

79 Ferdon Ave
Sparkill, NY 10976-1301
Phone (845) 365-9767

Other identifiers 1

IdentifierTypeStateIssuer
1858704MedicaidNY

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
I20061213000070 NY Practitioner - Pediatric Medicine 7214936616 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
100 of 100Reported as group
Promoting interoperability
100
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
219048NYMDLicensed Practical Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
Icahn School of Medicine at Mount Sinai CurrentSince May 17, 2015 Accepting new patients
Montefiore Medical Center CurrentSince Mar 11, 2016 Accepting new patients
Montefiore Medical Center CurrentSince Mar 11, 2016 Accepting new patients
Icahn School of Medicine at Mount Sinai CurrentSince May 17, 2015 Accepting new patients
Icahn School of Medicine at Mount Sinai 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

1428 Madison Ave
New York, NY 10029
Phone (212) 241-6947

1184 5th Ave
#2
New York, NY 10029
Phone (212) 241-3055

Networks

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

Organizations & group practices 5

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.

NPI Registry JSON

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

{
    "created_epoch": "1146700800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1302652800000",
    "number": "1023066198",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "79 FERDON AVE",
            "city": "SPARKILL",
            "state": "NY",
            "postal_code": "109761301",
            "telephone_number": "845-365-9767"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 GUSTAVE L LEVY PL",
            "address_2": "BOX 1497",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100296500",
            "telephone_number": "212-241-2478"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WASSERSTEIN",
        "first_name": "MELISSA",
        "middle_name": "PITTEL",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-05-04",
        "last_updated": "2011-04-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207SG0201X",
            "taxonomy_group": "",
            "desc": "Medical Genetics, Clinical Genetics (M.D.)",
            "state": "NY",
            "license": "194048",
            "primary": false
        },
        {
            "code": "207SG0202X",
            "taxonomy_group": "",
            "desc": "Medical Genetics, Clinical Biochemical Genetics",
            "state": "NY",
            "license": "194048",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1858704",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

Verify at the official NPI Registry.