Individual provider Active NPI

Alicia Latham, MD

  • Family Medicine Physician
  • New York, NY
National Provider Identifier
1023456845
Registry record updated Oct 23, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
293665 Issued in NY
Practice address
1275 York Ave
New York, NY 10065
Phone
(646) 888-4050
NPI assigned
Jun 14, 2013
Last updated
Oct 23, 2019By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 23, 2019

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 293665 NY Primary
Clinical Genetics (M.D.) Physician 207SG0201X 293665 NY

Addresses

Primary practice location

1275 York Ave
New York, NY 10065

Mailing address

1275 York Ave
New York, NY 10065-6007

Other practice location 1

155 Academy Ave
Greenwood, SC 29646-3869
Phone (864) 725-4869

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY, NJ2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20180831002031 NY Practitioner - Medical Genetics and GenomicsPractitioner - Family Practice 8325261779 Reassigns benefits to 2 organizations
I20230323001576 NJ Practitioner - Medical Genetics and GenomicsPractitioner - Family PracticePractitioner - Medical Oncology 8325261779 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Medical Genetics and GenomicsAlso: Family Practice
Education
Other, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Memorial Clinical Genetics GroupGroup PAC ID 6103837075, 10 clinicians
Memorial Medical Consultation GroupGroup PAC ID 6406755081, 82 clinicians

Practice addresses (Care Compare)

1275 York Ave
New York, NY 10065-6007
Phone (212) 639-2000

1275 York Ave
New York, NY 10065-6094
Phone (212) 639-2000

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
86.55 of 100Reported as group
Quality
82.52
Improvement activities
40
Cost
72.02

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Memorial Medical Consultation Group CurrentSince Jul 2, 2018 Accepting new patients
Memorial Clinical Genetics Group CurrentSince Jul 2, 2018 Accepting new patients

Locations

1275 York Ave
New York, NY 10065
Phone (212) 639-3813

633 3rd Ave
Fl 4
New York, NY 10017
Phone (646) 227-3764

633 3rd Ave
Lbby 3
New York, NY 10017
Phone (848) 225-6000

Networks

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

Interoperability endpoints

  • Direct secure messaging: alatham39098@mskcc.direct-ci.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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 5

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": "1371168000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1571788800000",
    "number": "1023456845",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1275 YORK AVE",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100656007"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1275 YORK AVE",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "10065",
            "telephone_number": "646-888-4050"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "155 Academy Ave",
            "address_purpose": "LOCATION",
            "city": "Greenwood",
            "state": "SC",
            "postal_code": "296463869",
            "country_code": "US",
            "telephone_number": "864-725-4869",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LATHAM",
        "first_name": "ALICIA",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2013-06-14",
        "last_updated": "2019-10-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NY",
            "license": "293665",
            "primary": true
        },
        {
            "code": "207SG0201X",
            "taxonomy_group": "",
            "desc": "Medical Genetics, Clinical Genetics (M.D.)",
            "state": "NY",
            "license": "293665",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

Verify at the official NPI Registry.