Individual provider Active NPI

Athanasia S Vasiliadis, MD

  • Internal Medicine Physician
  • New York, NY
National Provider Identifier
1093733818
Registry record updated Nov 1, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
191699 Issued in NY
Practice address
17 E 102ND St
New York, NY 10029-5204
Phone
(212) 659-8551
Fax
(212) 831-8116
NPI assigned
Jul 18, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 1, 2018

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 191699 NY Primary

Addresses

Primary practice location

17 E 102ND St
New York, NY 10029-5204

Mailing address

Box 3000
1Gustave L Levy Place
New York, NY 10029
Phone (212) 987-3100

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
I20050624000212 NY Practitioner - Internal Medicine 5395780837 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Icahn School of Medicine at Mount Sinai, 1991
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)

17 E 102ND St
New York, NY 10029-5204
Phone (212) 659-8551

5 E 98TH St
New York, NY 10029-6501
Phone (212) 241-3150

Hospital & facility affiliations

  • Mount Sinai Hospital Hospital, New York, NY, CCN 330024

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Icahn School of Medicine at Mount Sinai Internal Medicine CurrentSince Aug 1, 2012 Accepting new patients
Icahn School of Medicine at Mount Sinai CurrentSince Aug 1, 2012 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

17 E 102nd St
#1180
New York, NY 10029
Phone (212) 659-8557

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

1470 Madison Ave
#1087
New York, NY 10029
Phone (212) 241-0349

1470 Madison Ave
New York, NY 10029
Phone (212) 241-0806

Networks

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

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 6

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": "1153180800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1541030400000",
    "number": "1093733818",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "BOX 3000",
            "address_2": "1GUSTAVE L LEVY PLACE",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "10029",
            "telephone_number": "212-987-3100",
            "fax_number": "212-731-5210"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17 E 102ND ST",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100295204",
            "telephone_number": "212-659-8551",
            "fax_number": "212-831-8116"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VASILIADIS",
        "first_name": "ATHANASIA",
        "middle_name": "S",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-18",
        "last_updated": "2018-11-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NY",
            "license": "191699",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

Verify at the official NPI Registry.