NPIMap

Weill Medical College of Cornell

Organization Active NPI Internal Medicine Physician · New York, NY

NPI 1124170212 · NPPES record last updated Aug 26, 2015

Key facts

NPI
1124170212
Entity type
Organization (NPI type 2)
Primary specialty
Internal Medicine Physician 207R00000X
Legal business name
WEILL MEDICAL COLLEGE OF CORNELL
Practice address
1300 York Ave
Box 585
New York, NY 10021-4805
Phone
(212) 590-5741
NPI assigned
Jan 17, 2007
Organization subpart
No

Authorized official

Name
Ann F Adenbaum
Title
Senior Director Pobo
Phone
(646) 962-5487

Other NPIs on the same Medicare enrollment 24

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

Corporate family (same tax ID) 22

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

Practitioners 1,009

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

View all 1,009

Medicare participation

Medicare fee-for-service enrollment
Enrolled (3 enrollments) in NY

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
O20031118000661 NY Part B Supplier - Clinic/Group Practice 6800709023 Receives reassigned benefits from 985 practitioners
18 other NPIs on this enrollment
O20040305000512 NY Part B Supplier - Clinic/Group Practice 6800709023 Receives reassigned benefits from 111 practitioners
5 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: New York, NY
O20040719001355 NY Part B Supplier - Clinic/Group Practice 6800709023 Receives reassigned benefits from 12 practitioners
1 other NPI on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: New York, NY

National Provider Directory

Tax ID family
Edwina Sai Kho (90 organizations share this tax ID)

Locations

1300 York Ave
#585
New York, NY 10065

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology Physician
Group: 193200000X MULTI-SPECIALTY GROUP		 207L00000X
Dermatology Physician
Group: 193200000X MULTI-SPECIALTY GROUP		 207N00000X
Emergency Medicine Physician
Group: 193200000X MULTI-SPECIALTY GROUP		 207P00000X
Internal Medicine Physician
Group: 193200000X MULTI-SPECIALTY GROUP		 207R00000X Yes
Neurological Surgery Physician
Group: 193200000X MULTI-SPECIALTY GROUP		 207T00000X
Obstetrics & Gynecology Physician
Group: 193200000X MULTI-SPECIALTY GROUP		 207V00000X
Ophthalmology Physician
Group: 193200000X MULTI-SPECIALTY GROUP		 207W00000X
Otolaryngology Physician
Group: 193200000X MULTI-SPECIALTY GROUP		 207Y00000X
Clinical Pathology/Laboratory Medicine Physician
Group: 193200000X MULTI-SPECIALTY GROUP		 207ZP0105X
Pediatrics Physician
Group: 193200000X MULTI-SPECIALTY GROUP		 208000000X
Physical Medicine & Rehabilitation Physician
Group: 193200000X MULTI-SPECIALTY GROUP		 208100000X
Psychiatry Physician
Group: 193200000X MULTI-SPECIALTY GROUP		 2084P0800X
Diagnostic Radiology Physician
Group: 193200000X MULTI-SPECIALTY GROUP		 2085R0202X
Surgery Physician
Group: 193200000X MULTI-SPECIALTY GROUP		 208600000X
Urology Physician
Group: 193200000X MULTI-SPECIALTY GROUP		 208800000X

Addresses

Primary practice location

1300 York Ave
Box 585
New York, NY 10021-4805

Mailing address

PO Box 30107
New York, NY 10087-0107
Phone (646) 962-5487

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on Aug 26, 2015.

{
    "created_epoch": "1168992000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1440547200000",
    "number": "1124170212",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 30107",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100870107",
            "telephone_number": "646-962-5487",
            "fax_number": "646-962-0293"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1300 YORK AVE",
            "address_2": "BOX 585",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100214805",
            "telephone_number": "212-590-5741"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WEILL MEDICAL COLLEGE OF CORNELL",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-17",
        "last_updated": "2015-08-26",
        "status": "A",
        "authorized_official_last_name": "ADENBAUM",
        "authorized_official_first_name": "ANN",
        "authorized_official_middle_name": "F",
        "authorized_official_title_or_position": "SENIOR DIRECTOR POBO",
        "authorized_official_telephone_number": "646-962-5487"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Anesthesiology",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207N00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dermatology",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Emergency 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": "207T00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Neurological Surgery",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207V00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Obstetrics & Gynecology",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207W00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Ophthalmology",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207Y00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Otolaryngology",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207ZP0105X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Pathology, Clinical Pathology/Laboratory Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Pediatrics",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "208100000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physical Medicine & Rehabilitation",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2085R0202X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Radiology, Diagnostic Radiology",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "208600000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Surgery",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "208800000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Urology",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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