Individual provider Active NPI

David R. Edelstein, M.D.

  • Plastic Surgery within the Head & Neck (Otolaryngology) Physician
  • New York, NY
National Provider Identifier
1063570083
Registry record updated Aug 7, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Plastic Surgery within the Head & Neck (Otolaryngology) PhysicianTaxonomy code 207YX0007X
License
149360 Issued in NY
Practice address
1421 3Rd Ave
4TH FLR
New York, NY 10028-1802
Phone
(212) 452-1500
Fax
(212) 472-3086
NPI assigned
Dec 4, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 7, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Plastic Surgery within the Head & Neck (Otolaryngology) Physician 207YX0007X 149360 NY Primary

Addresses

Primary practice location

1421 3Rd Ave
4TH FLR
New York, NY 10028-1802

Mailing address

1421 3Rd Ave
4TH FLR
New York, NY 10028-1802
Phone (212) 452-1500

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
I20060208000619 NY Practitioner - Otolaryngology 5294740569 Receives reassigned benefits from 3 practitioners
Practice locations: New York, NY

Care Compare profile

Medicare Care Compare
Specialty
Otolaryngology
Education
Boston University School of Medicine, 1980
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

1421 3Rd Ave
Apt 4
New York, NY 10028-1933
Phone (212) 452-1500

210 E 64TH St
FL 3
New York, NY 10065-7471
Phone (212) 452-1500

Hospital & facility affiliations

  • Lenox Hill Hospital Hospital, New York, NY, CCN 330119

Merit-based Incentive Payment System (MIPS)

Final score
96.84 of 100Reported as individual
Quality
93.68
Improvement activities
40

National Provider Directory

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

Interoperability endpoints

  • Direct secure messaging: dedelstein67521@northwell.direct-ci.com
  • Direct secure messaging: dae2001@direct.nyp.org

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1165190400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1344297600000",
    "number": "1063570083",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1421 3RD AVE",
            "address_2": "4TH FLR",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100281802",
            "telephone_number": "212-452-1500",
            "fax_number": "212-472-3086"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1421 3RD AVE",
            "address_2": "4TH FLR",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100281802",
            "telephone_number": "212-452-1500",
            "fax_number": "212-472-3086"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EDELSTEIN",
        "first_name": "DAVID",
        "middle_name": "R.",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-12-04",
        "last_updated": "2012-08-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207YX0007X",
            "taxonomy_group": "",
            "desc": "Otolaryngology, Plastic Surgery within the Head & Neck",
            "state": "NY",
            "license": "149360",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

Verify at the official NPI Registry.