Active NPI
Traci Toll-Griffin, MD
- Pediatrics Physician
- Brewster, NY
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatrics Physician
- License
- 214615
- Practice address
- Mount Kisco Medical Group, PC
Southeast Executive Park, 185 Route 312
Brewster, NY 10509 - Phone
- (845) 278-7000
- Fax
- (914) 242-1516
- NPI assigned
- May 23, 2006
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatrics Physician | 208000000X | 214615 | NY | Primary |
Addresses
Primary practice location
Mount Kisco Medical Group, PC
Southeast Executive Park, 185 Route 312
Brewster, NY 10509
Mailing address
Mount Kisco Medical Group, PC
90 South Bedford Road
Mount Kisco, NY 10549-3412
Phone (914) 241-1050
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 02153088 | Medicaid | NY |
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
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Pediatric Medicine
- Education
- Other, 1998
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
90 S Bedford Rd
Mount Kisco, NY 10549-3412
Phone (914) 241-1050
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 214615 | NY | MD | Pediatrics Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Optum Medical Care, P.C. | Current | Accepting new patients | |
| Optum Medical Care, P.C. | Current | Accepting new patients |
Locations
185 Route 312
Brewster, NY 10509
Phone (845) 225-2700
90 S Bedford Rd
Mount Kisco, NY 10549
Phone (914) 242-1050
110 S Bedford Rd
Mount Kisco, NY 10549
Phone (763) 910-9192
Philadelphia, PA 19195
Networks
- Healthfirst Medicare Network H5989
- Healthfirst Medicare Network H9678
- Healthfirst Medicare Network H3359
- Healthfirst Medicare Network H1722
Interoperability endpoints
- ttollgriffin143668@direct.optum.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.
-
dba CareMount Medical, P.C.
- Cardiovascular Disease Physician
- Mount Kisco, NY
- NPI 1982643003
-
- Durable Medical Equipment & Medical Supplies
- New Hyde Park, NY
- NPI 1053190595
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1148342400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1259107200000",
"number": "1063467520",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "MOUNT KISCO MEDICAL GROUP, PC",
"address_2": "90 SOUTH BEDFORD ROAD",
"city": "MOUNT KISCO",
"state": "NY",
"postal_code": "105493412",
"telephone_number": "914-241-1050",
"fax_number": "914-242-1516"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "MOUNT KISCO MEDICAL GROUP, PC",
"address_2": "SOUTHEAST EXECUTIVE PARK, 185 ROUTE 312",
"city": "BREWSTER",
"state": "NY",
"postal_code": "10509",
"telephone_number": "845-278-7000",
"fax_number": "914-242-1516"
}
],
"practiceLocations": [],
"basic": {
"last_name": "TOLL-GRIFFIN",
"first_name": "TRACI",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-05-23",
"last_updated": "2009-11-25",
"status": "A"
},
"taxonomies": [
{
"code": "208000000X",
"taxonomy_group": "",
"desc": "Pediatrics",
"state": "NY",
"license": "214615",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "02153088",
"state": "NY"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Brewster, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 25, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.