NPIMap

Individual provider Active NPI

Jeremy David Mudd, MD

  • Pulmonary Disease Physician
  • New York, NY
National Provider Identifier
1083111306
Registry record updated May 1, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pulmonary Disease PhysicianTaxonomy code 207RP1001X
License
332712 Issued in NY
Practice address
10 E 102ND St
New York, NY 10029-0307
Phone
(212) 241-5656
NPI assigned
Apr 12, 2018
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 1, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pulmonary Disease Physician 207RP1001X 332712 NY Primary

Addresses

Primary practice location

10 E 102ND St
New York, NY 10029-0307

Mailing address

1 Gustave L Levy PL # 1118
New York, NY 10029-6504

Other practice location 1

177 Fort Washington Ave
New York, NY 10032-3733
Phone (212) 305-6262

Other practice location 2

1 Gustave L Levy Pl
New York, NY 10029-6504
Phone (212) 241-5656

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
I20250513002386 NY Practitioner - Pulmonary DiseasePractitioner - Critical Care (Intensivists) 3678091725 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Pulmonary DiseaseAlso: Critical Care (Intensivists)
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Icahn School of Medicine at Mount SinaiGroup PAC ID 2264691070, 2,809 clinicians

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

State licenses

LicenseStateTypeSpecialty
332712NYMDLicensed Practical Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
Icahn School of Medicine at Mount Sinai Current Accepting new patients
Icahn School of Medicine at Mount Sinai Pulmonary Disease CurrentSince Jul 1, 2025 Accepting new patients
Icahn School of Medicine at Mount Sinai CurrentSince Jul 1, 2025 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

10 Union Sq E
New York, NY 10003
Phone (212) 253-6800

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

425 W 59th St
New York, NY 10019
Phone (212) 376-3180

Networks

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

Organizations & group practices 4

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": "1523491200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1746057600000",
    "number": "1083111306",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 GUSTAVE L LEVY PL # 1118",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100296504"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10 E 102ND ST",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100290307",
            "telephone_number": "212-241-5656"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "177 Fort Washington Ave",
            "address_purpose": "LOCATION",
            "city": "New York",
            "state": "NY",
            "postal_code": "100323733",
            "country_code": "US",
            "telephone_number": "212-305-6262",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1 Gustave L Levy Pl",
            "address_purpose": "LOCATION",
            "city": "New York",
            "state": "NY",
            "postal_code": "100296504",
            "country_code": "US",
            "telephone_number": "212-241-5656",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MUDD",
        "first_name": "JEREMY",
        "middle_name": "DAVID",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-04-12",
        "last_updated": "2025-05-01",
        "certification_date": "2025-05-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RP1001X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Pulmonary Disease",
            "state": "NY",
            "license": "332712",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

Verify at the official NPI Registry.