NPIMap

Icahn School of Medicine at Mount Sinai

Organization Active NPI Urology Physician · New York, NY

NPI 1083083604 · NPPES record last updated Sep 24, 2015

Key facts

NPI
1083083604
Entity type
Organization (NPI type 2)
Primary specialty
Urology Physician 208800000X
Legal business name
ICAHN SCHOOL OF MEDICINE AT MOUNT SINAI
Practice address
10 Union Square East
New York, NY 10003
Phone
(212) 844-8900
NPI assigned
Sep 24, 2015
Organization subpart
No

Authorized official

Name
Ms. Crystal Macneill
Title
Vice President, Cbo Director
Phone
(646) 605-8112

Other NPIs on the same Medicare enrollment 17

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

Corporate family (same tax ID) 22

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

Practitioners 8

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

Medicare participation

Medicare fee-for-service enrollment
Enrolled in NY

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
O20151221001450 NY Part B Supplier - Clinic/Group Practice 4486955267 Receives reassigned benefits from 348 practitioners
17 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment

National Provider Directory

Tax ID family
Icahn School of Medicine at Mount Sinai (23 organizations share this tax ID)

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Urology Physician
Group: 193200000X MULTI-SPECIALTY GROUP		 208800000X Yes

Addresses

Primary practice location

10 Union Square East
New York, NY 10003

Mailing address

150 East 42ND Street
10TH Floor
New York, NY 10017
Phone (646) 605-8119

Other names

  • Urology Department of Mount Sinai BI Doing business as

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on Sep 24, 2015.

{
    "created_epoch": "1443052800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1443052800000",
    "number": "1083083604",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "150 EAST 42ND STREET",
            "address_2": "10TH FLOOR",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "10017",
            "telephone_number": "646-605-8119"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10 UNION SQUARE EAST",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "10003",
            "telephone_number": "212-844-8900"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ICAHN SCHOOL OF MEDICINE AT MOUNT SINAI",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-09-24",
        "last_updated": "2015-09-24",
        "status": "A",
        "authorized_official_last_name": "MACNEILL",
        "authorized_official_first_name": "CRYSTAL",
        "authorized_official_title_or_position": "VICE PRESIDENT, CBO DIRECTOR",
        "authorized_official_telephone_number": "646-605-8112",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "208800000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Urology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Urology Department of Mount Sinai BI",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in New York, NY

All providers in New York, NY · Urology Physician in New York

Sources for this page

Verify at the official NPI Registry.