Individual provider Active NPI

Cathy Anne Carron, MD

  • Internal Medicine Physician
  • New York, NY
National Provider Identifier
1043256290
Registry record updated Apr 24, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
1676231 Issued in NY
Practice address
65 Broadway
New York, NY 10006-2503
Phone
(212) 784-0073
Fax
(212) 784-0076
NPI assigned
Jun 22, 2006
Reactivated
Apr 15, 2024
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 24, 2024

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 1676231 NY Primary

Addresses

Primary practice location

65 Broadway
New York, NY 10006-2503

Mailing address

65 Broadway Ste 1806
New York, NY 10006-2517
Phone (212) 784-0073

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
I20040612000583 NY Practitioner - Internal Medicine 3173506730 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Rutgers New Jersey Medical School, 1983
Medicare assignment
May accept Medicare assignment
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

65 Broadway
Suite 1806
New York, NY 10006-2517
Phone (212) 784-0073

Hospital & facility affiliations

  • NYU Langone Hospitals Hospital, New York, NY, CCN 330214

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
1676231NYMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Cathy Carron a Signature MD PLLC Internal Medicine CurrentSince Feb 27, 2024 Accepting new patients
Metamorphyx Medical Group PC Internal Medicine PastSince Apr 1, 2004 Accepting new patients

Locations

65 Broadway
Ste 1806
New York, NY 10006
Phone (212) 482-2400

111 Broadway
Rm 902
New York, NY 10006
Phone (212) 784-0072

Interoperability endpoints

  • Direct secure messaging: ccarron4233@nyumc.direct-ci.com

Organizations & group practices 2

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 7

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": "1150934400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1713916800000",
    "number": "1043256290",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "65 BROADWAY STE 1806",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100062517",
            "telephone_number": "212-784-0073",
            "fax_number": "212-784-0076"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "65 BROADWAY",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100062503",
            "telephone_number": "212-784-0073",
            "fax_number": "212-784-0076"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CARRON",
        "first_name": "CATHY",
        "middle_name": "ANNE",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-06-22",
        "last_updated": "2024-04-24",
        "certification_date": "2024-04-24",
        "deactivation_date": "2024-03-27",
        "reactivation_date": "2024-04-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NY",
            "license": "1676231",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

Verify at the official NPI Registry.