Individual provider Active NPI

Satish K Tickoo, MD

  • Anatomic Pathology & Clinical Pathology Physician
  • New York, NY
National Provider Identifier
1114907904
Registry record updated Apr 7, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anatomic Pathology & Clinical Pathology PhysicianTaxonomy code 207ZP0102X
License
220784 Issued in NY
Practice address
1275 York Ave
New York, NY 10021-6007
Phone
(212) 639-2000
NPI assigned
Jan 19, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 7, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Anatomic Pathology & Clinical Pathology Physician 207ZP0102X 220784 NY Primary

Addresses

Primary practice location

1275 York Ave
New York, NY 10021-6007

Mailing address

633 3Rd Ave
Box 3
New York, NY 10017-6706

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
I20050317001091 NY Practitioner - Pathology 1153376512 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Pathology
Education
Other, 1982
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Memorial Pathology GroupGroup PAC ID 0749179158, 98 clinicians

Practice addresses (Care Compare)

1275 York Ave
New York, NY 10065-6007
Phone (212) 639-2000

Hospital & facility affiliations

  • Memorial Hospital for Cancer and Allied Diseases Hospital, New York, NY, CCN 330154

Merit-based Incentive Payment System (MIPS)

Final score
76.67 of 100Reported as group
Quality
70
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
001140NYMDPsychoanalyst
220784NYMDAnatomic Pathology & Clinical Pathology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Memorial Pathology Group Anatomic Pathology & Clinical Pathology CurrentSince Jan 15, 1998 Accepting new patients
Weill Medical College of Cornell Past Accepting new patients
MSK-Guttman Diagnostic Center Past Accepting new patients

Locations

633 3rd Ave
Lbby 3
New York, NY 10017
Phone (848) 225-6000

1275 York Ave
New York, NY 10065
Phone (212) 639-3813

Networks

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

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 5

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": "1137628800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1428364800000",
    "number": "1114907904",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "633 3RD AVE",
            "address_2": "BOX 3",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100176706"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1275 YORK AVE",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100216007",
            "telephone_number": "212-639-2000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TICKOO",
        "first_name": "SATISH",
        "middle_name": "K",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-01-19",
        "last_updated": "2015-04-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207ZP0102X",
            "taxonomy_group": "",
            "desc": "Pathology, Anatomic Pathology & Clinical Pathology",
            "state": "NY",
            "license": "220784",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

Verify at the official NPI Registry.