NPIMap

Individual provider Active NPI

Nicole NG, M.D., PHARM.D.

  • Pulmonary Disease Physician
  • New York, NY
National Provider Identifier
1073892907
Registry record updated May 13, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pulmonary Disease PhysicianTaxonomy code 207RP1001X
License
297449 Issued in NY
Practice address
1 Gustave L Levy PL
New York, NY 10029-6504
Phone
(212) 241-5656
Fax
(212) 241-8866
NPI assigned
Aug 9, 2011
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 13, 2022

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 055769 NY
Student in an Organized Health Care Education/Training Program 390200000X NY
Pulmonary Disease Physician 207RP1001X 297449 NY Primary

Addresses

Primary practice location

1 Gustave L Levy PL
New York, NY 10029-6504

Mailing address

622 W 168TH St
New York, NY 10032-3720
Phone (212) 305-6262

Other practice location 1

10 E 102nd St
New York, NY 10029-6030
Phone (212) 241-5656

Other practice location 2

622 W 168th St
New York, NY 10032-3720
Phone (212) 305-6262

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20220722001899 NY Practitioner - Pulmonary Disease 4688905656 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Pulmonary Disease
Education
Albert Einstein College of Medicine of Yeshiva University, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

10 E 102ND St
New York, NY 10029-6030
Phone (212) 241-9410

Hospital & facility affiliations

  • Mount Sinai Hospital Hospital, New York, NY, CCN 330024
  • Mount Sinai Beth Israel Hospital, New York, NY, CCN 330169

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
055769NYMDPharmacist
297449NYMDPulmonary Disease Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Icahn School of Medicine at Mount Sinai Pulmonary Disease CurrentSince Jul 1, 2022 Accepting new patients
Icahn School of Medicine at Mount Sinai Current Accepting new patients
Icahn School of Medicine at Mount Sinai Past Accepting new patients

Locations

200 Old Country Rd
Mineola, NY 11501
Phone (516) 408-4900

17 E 102nd St
New York, NY 10029
Phone (212) 241-7968

10 E 102nd St
New York, NY 10029
Phone (212) 241-5656

10 Union Sq E
Ste 3E
New York, NY 10003
Phone (212) 420-2377

Networks

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

Organizations & group practices 3

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.

Hospital & facility affiliations 9

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": "1312848000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1652400000000",
    "number": "1073892907",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "622 W 168TH ST",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100323720",
            "telephone_number": "212-305-6262"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 GUSTAVE L LEVY PL",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100296504",
            "telephone_number": "212-241-5656",
            "fax_number": "212-241-8866"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "10 E 102nd St",
            "address_purpose": "LOCATION",
            "city": "New York",
            "state": "NY",
            "postal_code": "100296030",
            "country_code": "US",
            "telephone_number": "212-241-5656",
            "fax_number": "212-241-8866",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "622 W 168th St",
            "address_purpose": "LOCATION",
            "city": "New York",
            "state": "NY",
            "postal_code": "100323720",
            "country_code": "US",
            "telephone_number": "212-305-6262",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "NG",
        "first_name": "NICOLE",
        "credential": "M.D., PHARM.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-08-09",
        "last_updated": "2022-05-13",
        "certification_date": "2022-05-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "NY",
            "license": "055769",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "NY",
            "license": null,
            "primary": false
        },
        {
            "code": "207RP1001X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Pulmonary Disease",
            "state": "NY",
            "license": "297449",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

Verify at the official NPI Registry.