NPIMap

Organization Active NPI

Bronxcare Health System

  • Psychiatry Physician
  • Bronx, NY
National Provider Identifier
1073806519
Registry record updated Mar 10, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
Legal business name
BRONXCARE HEALTH SYSTEM
Practice address
1276 Fulton Ave
Bronx, NY 10456-3402
Phone
(718) 901-8920
NPI assigned
May 17, 2011
Last updated
Mar 10, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 10, 2020

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

Authorized official

Name
Mr. Victor Demarco
Title
Sr Vo/Cfo
Phone
(718) 901-8600

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician 2084P0800X NU Primary

Addresses

Primary practice location

1276 Fulton Ave
Bronx, NY 10456-3402

Mailing address

1276 Fulton Ave # 3F
Bronx, NY 10456-3402
Phone (718) 901-8600

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040526001082 NY Part B Supplier - Clinic/Group Practice 3870404429 Receives reassigned benefits from 833 practitioners
18 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Bronx, NY; West Harrison, NY

Other NPIs on the same Medicare enrollment 18

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

View all 18

National Provider Directory

National Provider Directory
Tax ID family
BLHC OBGYN GRP28 organizations share this tax ID, including this one

Other organizations with this tax ID 27

Organizations that report the same tax identification number in the National Provider Directory.

View all 27

Locations

1276 Fulton Ave
#208
Bronx, NY 10456
Phone (718) 901-8911

1276 Fulton Ave
#3F
Bronx, NY 10456
Phone (718) 901-8294

Practitioners & affiliated clinicians

Practitioners 61

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 61

NPI Registry JSON

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

{
    "created_epoch": "1305590400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1583798400000",
    "number": "1073806519",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1276 FULTON AVE # 3F",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "104563402",
            "telephone_number": "718-901-8600"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1276 FULTON AVE",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "104563402",
            "telephone_number": "718-901-8920"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BRONXCARE HEALTH SYSTEM",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-05-17",
        "last_updated": "2020-03-10",
        "certification_date": "2020-03-10",
        "status": "A",
        "authorized_official_last_name": "DEMARCO",
        "authorized_official_first_name": "VICTOR",
        "authorized_official_title_or_position": "SR VO/CFO",
        "authorized_official_telephone_number": "718-901-8600",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bronx, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 10, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.