Individual provider Active NPI

Nelly Maria Maseda, M.D.

  • Pediatrics Physician
  • Bronx, NY
National Provider Identifier
1063410041
Registry record updated Sep 12, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
182271 Issued in NY
Practice address
1225 Gerard Ave FL 2
Bronx, NY 10452-8015
Phone
(718) 960-2777
Fax
(187) 960-2912
NPI assigned
Jul 13, 2005
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 12, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 180271 NY
Pediatrics Physician 208000000X 182271 NY Primary

Addresses

Primary practice location

1225 Gerard Ave FL 2
Bronx, NY 10452-8015

Mailing address

1225 Gerard Ave FL 2
Bronx, NY 10452-8015
Phone (718) 960-2777

Other practice location 1

234 E 149th St
Bronx, NY 10451-5504
Phone (718) 579-5006

Other identifiers 1

IdentifierTypeStateIssuer
01271030MedicaidNY

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
I20110831000369 NY Practitioner - Pediatric Medicine 7618147646 Reassigns benefits to 5 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
180271NYMDPediatrics Physician
182271NYMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Montefiore Medical Center Pediatrics CurrentSince Mar 5, 2015 Accepting new patients
Harlem Medical Associates PC CurrentSince Jan 3, 2018 Accepting new patients
New York City Health and Hospitals Corporation CurrentSince Mar 3, 2021 Accepting new patients
Downtown Bronx Medical Associates PC CurrentSince Sep 11, 2023 Accepting new patients
New York City Health and Hospitals Corporation Current Accepting new patients
Physician Affiliate Group of New York PC CurrentSince Sep 21, 2024 Accepting new patients
New York City Health and Hospitals Corporation CurrentSince Mar 3, 2021 Accepting new patients
Kidney Medical Associates PLLC Past Accepting new patients

Locations

2100 Bartow Ave
Bronx, NY 10475
Phone (718) 320-5300

111 E 210th St
Bronx, NY 10467

234 Eugenio Maria de Hosto Blvd
Bronx, NY 10451
Phone (718) 579-5874

1650 Grand Concourse
Bronx, NY 10457
Phone (718) 294-7104

234 E 149th St
Rm 8D200
Bronx, NY 10451

1225 Gerard Ave
Fl 2
Bronx, NY 10452
Phone (718) 960-2777

1225 Gerard Ave
Bronx, NY 10452
Phone (718) 960-2777

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

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

227 Madison St
New York, NY 10002
Phone (212) 238-7000

50 Water St
Fl 3
New York, NY 10004

Networks

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

Interoperability endpoints

  • Direct secure messaging: nmaseda679164@nychhc.direct-ci.com

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1121212800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1694476800000",
    "number": "1063410041",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1225 GERARD AVE FL 2",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "104528015",
            "telephone_number": "718-960-2777",
            "fax_number": "718-960-2912"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1225 GERARD AVE FL 2",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "104528015",
            "telephone_number": "718-960-2777",
            "fax_number": "187-960-2912"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "234 E 149th St",
            "address_purpose": "LOCATION",
            "city": "Bronx",
            "state": "NY",
            "postal_code": "104515504",
            "country_code": "US",
            "telephone_number": "718-579-5006",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MASEDA",
        "first_name": "NELLY",
        "middle_name": "MARIA",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-07-13",
        "last_updated": "2023-09-12",
        "certification_date": "2023-08-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "NY",
            "license": "180271",
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "NY",
            "license": "182271",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01271030",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Bronx, NY

Sources for this page

Verify at the official NPI Registry.