Individual provider Active NPI

Michael Correa, MD

  • Internal Medicine Physician
  • New York, NY
National Provider Identifier
1083765531
Registry record updated Apr 25, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
215842 Issued in NY
Practice address
1302 Amsterdam Ave
New York, NY 10027-4281
Phone
(212) 665-8012
Fax
(212) 665-0233
NPI assigned
Jan 12, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 25, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 215842 NY Primary

Addresses

Primary practice location

1302 Amsterdam Ave
New York, NY 10027-4281

Mailing address

1302 Amsterdam Ave
New York, NY 10027-4244
Phone (212) 665-8012

Other identifiers 1

IdentifierTypeStateIssuer
00354967060MedicaidNY

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040610001842 NY Practitioner - Internal Medicine 7214910116 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Rutgers R W Johnson Medical School (Cam/New Bruns/Pisc), 1998
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Michael Correa MD PCGroup PAC ID 6406932714, 2 clinicians

Practice addresses (Care Compare)

1302 Amsterdam Ave
New York, NY 10027-4244
Phone (212) 665-8012

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Michael Correa MD PC Internal Medicine CurrentSince Dec 1, 2007 Accepting new patients
North Shore-Lij Medical PC Internal Medicine Past Accepting new patients
St Lukes Roosevelt Community Care Internal Medicine Past Accepting new patients

Locations

1302 Amsterdam Ave
New York, NY 10027
Phone (212) 665-8012

Networks

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

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/EGJFAA
  • FHIR API: https://fhir4.healow.com/fhir/r4/EGJFAA/Endpoint/EGJFAA

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 1

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": "1168560000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1493078400000",
    "number": "1083765531",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1302 AMSTERDAM AVE",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100274244",
            "telephone_number": "212-665-8012",
            "fax_number": "212-222-8905"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1302 AMSTERDAM AVE",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100274281",
            "telephone_number": "212-665-8012",
            "fax_number": "212-665-0233"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CORREA",
        "first_name": "MICHAEL",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-01-12",
        "last_updated": "2017-04-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NY",
            "license": "215842",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00354967060",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

Verify at the official NPI Registry.