Individual provider Active NPI

Rita Dennise Moncayo Wilches

  • Student in an Organized Health Care Education/Training Program
  • Brooklyn, NY
National Provider Identifier
1063156024
Registry record updated Feb 21, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Student in an Organized Health Care Education/Training ProgramTaxonomy code 390200000X
Practice address
Maimonides Medical Center
4802 10TH Avenue
Brooklyn, NY 11219
Phone
(718) 283-6000
NPI assigned
Apr 26, 2022
Last updated
Feb 21, 2023By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 21, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X Primary

Addresses

Primary practice location

Maimonides Medical Center
4802 10TH Avenue
Brooklyn, NY 11219

Mailing address

Maimonides Medical Center
4802 10TH Avenue
Brooklyn, NY 11219
Phone (718) 283-6000

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
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
I20251217002813 CA Practitioner - Internal Medicine 4880189893 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 2017
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

500 Pasteur Dr
RM P388
Palo Alto, CA 94304-1048

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Stanford Health Care CurrentSince Dec 5, 2025 Accepting new patients
LPCH Medical Group Div of Lucile CurrentSince Dec 5, 2025 Accepting new patients
Stanford Health Care CurrentSince Dec 5, 2025 Accepting new patients

Locations

725 Welch Rd
Palo Alto, CA 94304
Phone (650) 497-8979

300 Pasteur Dr
Stanford, CA 94305
Phone (650) 498-5710

Interoperability endpoints

  • Direct secure messaging: rita.moncayowilches.p1@direct.mmc.nextgenshare.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.

NPI Registry JSON

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

{
    "created_epoch": "1650931200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1676937600000",
    "number": "1063156024",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "MAIMONIDES MEDICAL CENTER",
            "address_2": "4802 10TH AVENUE",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "11219",
            "telephone_number": "718-283-6000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "MAIMONIDES MEDICAL CENTER",
            "address_2": "4802 10TH AVENUE",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "11219",
            "telephone_number": "718-283-6000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MONCAYO WILCHES",
        "first_name": "RITA",
        "middle_name": "DENNISE",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2022-04-26",
        "last_updated": "2023-02-21",
        "certification_date": "2023-02-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brooklyn, NY

Sources for this page

Verify at the official NPI Registry.