NPIMap

Organization Active NPI

Montefiore Nyack Hospital

  • Neurology Physician
  • Nyack, NY
National Provider Identifier
1073881835
Registry record updated Oct 25, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neurology PhysicianTaxonomy code 2084N0400X
Legal business name
MONTEFIORE NYACK HOSPITAL
Practice address
160 N Midland Ave
Nyack, NY 10960-1912
Phone
(845) 348-6607
NPI assigned
Dec 8, 2011
Last updated
Oct 25, 2018By the provider in NPPES
Organization subpart
Yes
Parent organization
NYACK HOSPITALAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Oct 25, 2018

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

Authorized official

Name
John Burke
Title
Chief Financial Officer
Phone
(845) 348-6607

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction Medicine (Family Medicine) Physician 207QA0401X NU
Neurology Physician 2084N0400X NU Primary

Addresses

Primary practice location

160 N Midland Ave
Nyack, NY 10960-1912

Mailing address

160 N Midland Ave
Nyack, NY 10960-1912
Phone (845) 348-6607

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20120216000200 NY Part B Supplier - Clinic/Group Practice 2668485046 Receives reassigned benefits from 125 practitioners
Practice locations: Nyack, NY; West Nyack, NY

Other NPIs with the same Medicare PAC ID 3

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

National Provider Directory

National Provider Directory
Part of
Physician Services Nyac

Practitioners & affiliated clinicians

Practitioners 128

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 128

NPI Registry JSON

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

{
    "created_epoch": "1323302400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1540425600000",
    "number": "1073881835",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "160 N MIDLAND AVE",
            "city": "NYACK",
            "state": "NY",
            "postal_code": "109601912",
            "telephone_number": "845-348-6607"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "160 N MIDLAND AVE",
            "city": "NYACK",
            "state": "NY",
            "postal_code": "109601912",
            "telephone_number": "845-348-6607"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MONTEFIORE NYACK HOSPITAL",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "NYACK HOSPITAL",
        "enumeration_date": "2011-12-08",
        "last_updated": "2018-10-25",
        "status": "A",
        "authorized_official_last_name": "BURKE",
        "authorized_official_first_name": "JOHN",
        "authorized_official_title_or_position": "CHIEF FINANCIAL OFFICER",
        "authorized_official_telephone_number": "845-348-6607"
    },
    "taxonomies": [
        {
            "code": "207QA0401X",
            "taxonomy_group": "",
            "desc": "Family Medicine, Addiction Medicine",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "2084N0400X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Nyack, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 25, 2018; 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.