Icahn School of Medicine at Mount Sinai
Organization Active NPI Emergency Medicine Physician · New York, NY
NPI 1124392238 · NPPES record last updated Jul 7, 2015
Key facts
- NPI
- 1124392238
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Emergency Medicine Physician 207P00000X
- Legal business name
- ICAHN SCHOOL OF MEDICINE AT MOUNT SINAI
- Practice address
- 638 Columbus Ave
New York, NY 10024-1406 - Phone
- (212) 731-7693
- NPI assigned
- Mar 7, 2012
- Organization subpart
- No
Authorized official
- Name
- Crystal Macneill
- Title
- VP, Cbo Director
- Phone
- (646) 605-8112
Practitioners 315
-
David Ben-Eli, MD
-
Erik Blutinger, M.D., M.SC.
-
Alex Bonilla, MD
-
Moira Carroll, M.D.
-
Louis V. Cicatelli, D.O.
-
Jamie Alison Edelstein, M.D.
-
Cortlyn Jeter, MD
-
Mark Mikhly, M.D.
-
Thomas Nguyen, MD
-
Dmitry Olshansky, M.D.
-
Matthew A. Pius, MD
-
Nina Ragaz, M.D.
-
Nidhish Sasi, M.D.
-
Turandot Saul, M.D.
-
Felipe Serrano, M.D.
-
Judah Sueker, MD
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in NY
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20140603000259 | NY | Part B Supplier - Clinic/Group Practice | 1850514258 |
Receives reassigned benefits from 312 practitioners Practice locations: New York, NY; Brooklyn, NY |
National Provider Directory
Locations
638 Columbus Ave
New York, NY 10024
Phone (212) 523-8672
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Emergency Medicine Physician |
207P00000X | NY | Yes |
Addresses
Primary practice location
638 Columbus Ave
New York, NY 10024-1406
Mailing address
150 East 42ND. Street
10TH FL.
New York, NY 10017-5626
Phone (646) 605-8119
Other names
- FPA Urgent Care Center
NPI Registry JSON
{
"created_epoch": "1331078400000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1436227200000",
"number": "1124392238",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "150 EAST 42ND. STREET",
"address_2": "10TH FL.",
"city": "NEW YORK",
"state": "NY",
"postal_code": "100175626",
"telephone_number": "646-605-8119",
"fax_number": "646-605-3029"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "638 COLUMBUS AVE",
"city": "NEW YORK",
"state": "NY",
"postal_code": "100241406",
"telephone_number": "212-731-7693"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "ICAHN SCHOOL OF MEDICINE AT MOUNT SINAI",
"organizational_subpart": "NO",
"enumeration_date": "2012-03-07",
"last_updated": "2015-07-07",
"status": "A",
"authorized_official_last_name": "MACNEILL",
"authorized_official_first_name": "CRYSTAL",
"authorized_official_title_or_position": "VP, CBO DIRECTOR",
"authorized_official_telephone_number": "646-605-8112"
},
"taxonomies": [
{
"code": "207P00000X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Emergency Medicine",
"state": "NY",
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"organization_name": "FPA Urgent Care Center",
"code": "3",
"type": "Doing Business As"
}
]
}Other providers in New York, NY
- Icahn School of Medicine at Mount Sinai
- Icahn School of Medicine at Mount Sinai
- Icahn School of Medicine at Mount Sinai
- Icahn School of Medicine at Mount Sinai
- Icahn School of Medicine at Mount Sinai
- Icahn School of Medicine at Mount Sinai
- Icahn School of Medicine at Mount Sinai
- Icahn School of Medicine at Mount Sinai
- Icahn School of Medicine at Mount Sinai
- Icahn School of Medicine at Mount Sinai
All providers in New York, NY · Emergency Medicine Physician in New York
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 7, 2015. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.