Individual provider Active NPI

Myrian Mercedes Alea, MD

  • Pediatric Emergency Medicine (Pediatrics) Physician
  • Bronx, NY
National Provider Identifier
1063484087
Registry record updated Dec 3, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Emergency Medicine (Pediatrics) PhysicianTaxonomy code 2080P0204X
License
299139 Issued in NY
Practice address
110 E 210TH St
Bronx, NY 10467
Phone
(718) 920-5312
Fax
(718) 798-6485
NPI assigned
Feb 3, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 3, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Emergency Medicine (Pediatrics) Physician 2080P0204X 299139 NY Primary

Addresses

Primary practice location

110 E 210TH St
Bronx, NY 10467

Mailing address

110 E 210TH St
Bronx, NY 10467-2402
Phone (718) 920-5312

Other practice location 1

110 E 210th St
Bronx, NY 10467
Phone (718) 920-5312

Other identifiers 2

IdentifierTypeStateIssuer
26277OtherFLBCBS
376549100MedicaidFL

Other names 1

  • Dr. Myrian Alea Professional name

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
I20190806000825 NY Practitioner - Pediatric Medicine 1355388794 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
299139NYMDLicensed Practical Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
Montefiore Medical Center CurrentSince Jun 21, 2019 Accepting new patients
Montefiore Medical Center CurrentSince Jun 21, 2019 Accepting new patients

Locations

111 E 210th St
Bronx, NY 10467

Networks

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

Interoperability endpoints

  • Direct secure messaging: malea@montefioredirect.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.

NPI Registry JSON

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

{
    "created_epoch": "1138924800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1575331200000",
    "number": "1063484087",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "110 E 210TH ST",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "104672402",
            "telephone_number": "718-920-5312",
            "fax_number": "718-798-6485"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "110 E 210TH ST",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "10467",
            "telephone_number": "718-920-5312",
            "fax_number": "718-798-6485"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "110 E 210th St",
            "address_purpose": "LOCATION",
            "city": "Bronx",
            "state": "NY",
            "postal_code": "10467",
            "country_code": "US",
            "telephone_number": "718-920-5312",
            "fax_number": "718-798-6485",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ALEA",
        "first_name": "MYRIAN",
        "middle_name": "MERCEDES",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-02-03",
        "last_updated": "2019-12-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2080P0204X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Emergency Medicine",
            "state": "NY",
            "license": "299139",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "26277",
            "state": "FL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "376549100",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MYRIAN",
            "last_name": "ALEA",
            "prefix": "DR.",
            "credential": "MD.",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

Other providers in Bronx, NY

Sources for this page

Verify at the official NPI Registry.