Individual provider Active NPI

Tomoko Ikuine, MD

  • Internal Medicine Physician
  • New York, NY
National Provider Identifier
1033614631
Registry record updated Dec 29, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
313383-01 Issued in NY
Practice address
947 Columbus Ave Apt 3B
New York, NY 10025-3180
Phone
(646) 662-3740
NPI assigned
Mar 26, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 29, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 313383-01 NY Primary

Addresses

Primary practice location

947 Columbus Ave Apt 3B
New York, NY 10025-3180

Mailing address

120 W 106 St
Attn Medical Dept
New York, NY 10025-3923
Phone (212) 870-5752

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
I20220105001719 NY Practitioner - Internal Medicine 0648661413 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Physician Affiliate Group of New York PCGroup PAC ID 4688098833, 1,222 clinicians

Practice addresses (Care Compare)

506 Lenox Ave
New York, NY 10037-1802
Phone (212) 939-1840

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
313383NYMDLicensed Practical Nurse
313383-01NYMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Harlem Medical Associates PC CurrentSince Jan 17, 2023 Accepting new patients
Jewish Home Lifecare, Manhattan CurrentSince Jan 3, 2022 Accepting new patients
Physician Affiliate Group of New York PC CurrentSince Mar 1, 2024 Accepting new patients
Jewish Home Lifecare, Manhattan CurrentSince Jan 3, 2022 Accepting new patients
New York City Health and Hospitals Corporation Internal Medicine Past Accepting new patients

Locations

2601 Ocean Pkwy
Brooklyn, NY 11235
Phone (718) 616-5354

120 W 106th St
New York, NY 10025
Phone (212) 870-4715

506 Malcolm X Blvd
New York, NY 10037
Phone (212) 939-1000

Networks

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

Interoperability endpoints

  • Direct secure messaging: tikuine3639304@nychhc.direct-ci.com

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.

Hospital & facility affiliations 6

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": "1522022400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1640736000000",
    "number": "1033614631",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "120 W 106 ST",
            "address_2": "ATTN MEDICAL DEPT",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100253923",
            "telephone_number": "212-870-5752",
            "fax_number": "212-870-4905"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "947 COLUMBUS AVE APT 3B",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100253180",
            "telephone_number": "646-662-3740"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "IKUINE",
        "first_name": "TOMOKO",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-03-26",
        "last_updated": "2021-12-29",
        "certification_date": "2021-12-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NY",
            "license": "313383-01",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

Verify at the official NPI Registry.