Individual provider Active NPI

Philip M Meyers, M.D.

  • Vascular & Interventional Radiology Physician
  • New York, NY
National Provider Identifier
1033119458
Registry record updated Dec 10, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Vascular & Interventional Radiology PhysicianTaxonomy code 2085R0204X
License
222575 Issued in NY
Practice address
710 W 168TH St
Neurological Institute, RM 404
New York, NY 10032-2603
Phone
(212) 305-6384
Fax
(121) 342-1229
NPI assigned
Jul 28, 2005
Last updated
Dec 10, 2020By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 10, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Neurological Surgery Physician 207T00000X 222575 NY
Vascular & Interventional Radiology Physician 2085R0204X 222575 NY Primary

Addresses

Primary practice location

710 W 168TH St
Neurological Institute, RM 404
New York, NY 10032-2603

Mailing address

710 W 168TH St
Neurological Institute, RM 428
New York, NY 10032-2603
Phone (212) 305-6384

Other identifiers 1

IdentifierTypeStateIssuer
02190036MedicaidNY

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
I20110314000868 NY Practitioner - Interventional RadiologyPractitioner - Diagnostic Radiology 5698957561 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
222575NYMDVascular & Interventional Radiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
St Lukes Clinic-Treasure Valley LLC CurrentSince Nov 1, 2020 Accepting new patients
St Lukes Clinic-Treasure Valley LLC CurrentSince Nov 1, 2020 Accepting new patients
Trustees of Columbia University in the City of New York CurrentSince Apr 1, 2019 Accepting new patients
Trustees of Columbia University in the City of New York Current Accepting new patients
Trustees of Columbia University in the City of New York Vascular & Interventional Radiology CurrentSince Apr 1, 2019 Accepting new patients
Trustees of Columbia University in the City of New York Past Accepting new patients
Valley Physician Services PC Past Accepting new patients
Trustees of Columbia University in the City of New York Past Accepting new patients

Locations

190 E Bannock St
Boise, ID 83712
Phone (208) 381-2378

610 W Hays St
Boise, ID 83702
Phone (208) 345-3530

500 Grand Ave
Fl 1
Englewood, NJ 07631
Phone (201) 227-1760

161 Fort Washington Ave
New York, NY 10032
Phone (212) 305-8559

622 W 168th St
New York, NY 10032
Phone (212) 305-4931

622 W 168th St
Ste G
New York, NY 10032
Phone (212) 305-6384

710 W 168th St
New York, NY 10032
Phone (212) 305-0217

710 W 168th St
Rm 404
New York, NY 10032
Phone (212) 305-6384

710 W 168th St
Rm 428
New York, NY 10032

710 W 168th St
Ste 425
New York, NY 10032
Phone (212) 305-1090

Interoperability endpoints

  • FHIR API: https://epicproxy-pub.et1089.epichosted.com/FHIRProxy/api/FHIR/DSTU2/
  • FHIR API: https://epicproxy-pub.et1089.epichosted.com/FHIRProxy/api/FHIR/R4/

Organizations & group practices 8

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.

NPI Registry JSON

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

{
    "created_epoch": "1122508800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1607558400000",
    "number": "1033119458",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "710 W 168TH ST",
            "address_2": "NEUROLOGICAL INSTITUTE, RM 428",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100322603",
            "telephone_number": "212-305-6384",
            "fax_number": "121-342-1229"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "710 W 168TH ST",
            "address_2": "NEUROLOGICAL INSTITUTE, RM 404",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100322603",
            "telephone_number": "212-305-6384",
            "fax_number": "121-342-1229"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MEYERS",
        "first_name": "PHILIP",
        "middle_name": "M",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-07-28",
        "last_updated": "2020-12-10",
        "certification_date": "2020-12-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207T00000X",
            "taxonomy_group": "",
            "desc": "Neurological Surgery",
            "state": "NY",
            "license": "222575",
            "primary": false
        },
        {
            "code": "2085R0204X",
            "taxonomy_group": "",
            "desc": "Radiology, Vascular & Interventional Radiology",
            "state": "NY",
            "license": "222575",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02190036",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

Verify at the official NPI Registry.