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Icahn School of Medicine at Mount Sinai

Organization Active NPI Internal Medicine Physician · New York, NY

NPI 1104366871 · NPPES record last updated Mar 1, 2017

Key facts

NPI
1104366871
Entity type
Organization (NPI type 2)
Primary specialty
Internal Medicine Physician 207R00000X
Legal business name
ICAHN SCHOOL OF MEDICINE AT MOUNT SINAI
Practice address
1000 10TH Ave
New York, NY 10019-1147
Phone
(212) 523-6500
NPI assigned
Mar 1, 2017
Organization subpart
No

Authorized official

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

Corporate family (same tax ID) 32

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

View all 32

National Provider Directory

Tax ID family
Icahn School of Medicine at (33 organizations share this tax ID)

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Dermatology Physician
Group: 193200000X MULTI-SPECIALTY GROUP		 207N00000X
Family Medicine Physician
Group: 193200000X MULTI-SPECIALTY GROUP		 207Q00000X
Internal Medicine Physician
Group: 193200000X MULTI-SPECIALTY GROUP		 207R00000X Yes
Obstetrics & Gynecology Physician
Group: 193200000X MULTI-SPECIALTY GROUP		 207V00000X
Pediatrics Physician
Group: 193200000X MULTI-SPECIALTY GROUP		 208000000X
Neurology Physician
Group: 193200000X MULTI-SPECIALTY GROUP		 2084N0400X
Geriatric Psychiatry Physician
Group: 193200000X MULTI-SPECIALTY GROUP		 2084P0805X
Nurse Practitioner
Group: 193200000X MULTI-SPECIALTY GROUP		 363L00000X

Addresses

Primary practice location

1000 10TH Ave
New York, NY 10019-1147

Mailing address

150 E 42ND St
10TH Floor
New York, NY 10017-5612
Phone (646) 605-8119

Other names

  • The Institute for Advanced Medicine 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 Mar 1, 2017.

{
    "created_epoch": "1488326400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1488326400000",
    "number": "1104366871",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "150 E 42ND ST",
            "address_2": "10TH FLOOR",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100175612",
            "telephone_number": "646-605-8119",
            "fax_number": "646-605-3031"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1000 10TH AVE",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100191147",
            "telephone_number": "212-523-6500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ICAHN SCHOOL OF MEDICINE AT MOUNT SINAI",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-03-01",
        "last_updated": "2017-03-01",
        "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": "207N00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dermatology",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "207V00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Obstetrics & Gynecology",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Pediatrics",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2084N0400X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2084P0805X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychiatry & Neurology, Geriatric Psychiatry",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "The Institute for Advanced Medicine",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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Sources for this page

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