Active NPI
Ig Medical PC
- Specialist
- New York, NY
National Provider Identifier
1104124924
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Specialist
- License
- 2363851
- Legal business name
- IG MEDICAL PC
- Practice address
- 570 W 204TH St Apt 1J
New York, NY 10034-4011 - Phone
- (212) 569-8070
- Fax
- (212) 569-8071
- NPI assigned
- Mar 2, 2011
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Igor Ryndin, MD
- Title
- Urology
- Phone
- (212) 569-8070
Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Specialist | 174400000X | 2363851 | NY | Primary |
Addresses
Primary practice location
570 W 204TH St Apt 1J
New York, NY 10034-4011
Mailing address
570 W 204TH St Apt 1J
New York, NY 10034-4011
Phone (212) 569-8070
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 02711255 | Medicaid | NY |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in NY
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20110609000244 | NY | Part B Supplier - Clinic/Group Practice | 2466639927 |
Receives reassigned benefits from 2 practitioners Practice locations: New York, NY |
National Provider Directory
National Provider Directory- Tax ID family
- Ig Medical
Other organizations with this tax ID 1
Organizations that report the same tax identification number in the National Provider Directory.
-
- Urology Physician
- New York, NY
- NPI 1194027755
Practitioners & affiliated clinicians
Practitioners 2
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1299024000000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1299024000000",
"number": "1104124924",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "570 W 204TH ST APT 1J",
"city": "NEW YORK",
"state": "NY",
"postal_code": "100344011",
"telephone_number": "212-569-8070",
"fax_number": "212-569-8071"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "570 W 204TH ST APT 1J",
"city": "NEW YORK",
"state": "NY",
"postal_code": "100344011",
"telephone_number": "212-569-8070",
"fax_number": "212-569-8071"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "IG MEDICAL PC",
"organizational_subpart": "NO",
"enumeration_date": "2011-03-02",
"last_updated": "2011-03-02",
"status": "A",
"authorized_official_last_name": "RYNDIN",
"authorized_official_first_name": "IGOR",
"authorized_official_title_or_position": "UROLOGY",
"authorized_official_telephone_number": "212-569-8070",
"authorized_official_credential": "MD"
},
"taxonomies": [
{
"code": "174400000X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Specialist",
"state": "NY",
"license": "2363851",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "02711255",
"state": "NY"
}
],
"endpoints": [],
"other_names": []
}Other providers in New York, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 2, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.