NPIMap

Organization Active NPI

Christopher Adubor Physician PC

  • Nephrology Physician
  • Mount Vernon, NY
National Provider Identifier
1043447808
Registry record updated Jun 18, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nephrology PhysicianTaxonomy code 207RN0300X
License
192587 Issued in NY
Legal business name
CHRISTOPHER ADUBOR PHYSICIAN PC
Practice address
153 Stevens Ave
Suite 4
Mount Vernon, NY 10550-2543
Phone
(914) 668-8080
Fax
(914) 668-0629
NPI assigned
Jun 18, 2009
Last updated
Jun 18, 2009By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 18, 2009

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

Authorized official

Name
Dr. Christopher Adubor, MDNPI 1962464594
Title
Medical Director
Phone
(914) 668-8080

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207R00000X 192587 NY
Nephrology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207RN0300X 192587 NY Primary

Addresses

Primary practice location

153 Stevens Ave
Suite 4
Mount Vernon, NY 10550-2543

Mailing address

153 Stevens Ave
Suite 4
Mount Vernon, NY 10550-2543
Phone (914) 668-8080

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20101214000022 NY Part B Supplier - Clinic/Group Practice 4385831593 Receives reassigned benefits from 1 practitioner
Practice locations: Mount Vernon, NY

National Provider Directory

National Provider Directory
Tax ID family
Mount Vernon Medical Practice4 organizations share this tax ID, including this one

Other organizations with this tax ID 3

Organizations that report the same tax identification number in the National Provider Directory.

Locations

153 Stevens Ave
Ste 4
Mount Vernon, NY 10550
Phone (914) 660-8080

Ownership & related parties

Subparts reporting this organization as parent 2

Organizations that report themselves as subparts in NPPES and name this organization, in the same state, as their parent.

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1245283200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1245283200000",
    "number": "1043447808",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "153 STEVENS AVE",
            "address_2": "SUITE 4",
            "city": "MOUNT VERNON",
            "state": "NY",
            "postal_code": "105502543",
            "telephone_number": "914-668-8080",
            "fax_number": "914-668-0629"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "153 STEVENS AVE",
            "address_2": "SUITE 4",
            "city": "MOUNT VERNON",
            "state": "NY",
            "postal_code": "105502543",
            "telephone_number": "914-668-8080",
            "fax_number": "914-668-0629"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CHRISTOPHER ADUBOR PHYSICIAN PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-06-18",
        "last_updated": "2009-06-18",
        "status": "A",
        "authorized_official_last_name": "ADUBOR",
        "authorized_official_first_name": "CHRISTOPHER",
        "authorized_official_title_or_position": "MEDICAL DIRECTOR",
        "authorized_official_telephone_number": "914-668-8080",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine",
            "state": "NY",
            "license": "192587",
            "primary": false
        },
        {
            "code": "207RN0300X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine, Nephrology",
            "state": "NY",
            "license": "192587",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mount Vernon, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 18, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.