NPIMap

Organization Active NPI

Icahn School of Medicine at Mount Sinai

Doing business as FPA Urgent Care Center

  • Emergency Medicine Physician
  • New York, NY
National Provider Identifier
1124392238
Registry record updated Jul 7, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
Legal business name
ICAHN SCHOOL OF MEDICINE AT MOUNT SINAI
Doing business as
FPA Urgent Care Center
Practice address
638 Columbus Ave
New York, NY 10024-1406
Phone
(212) 731-7693
NPI assigned
Mar 7, 2012
Last updated
Jul 7, 2015By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 7, 2015

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

Authorized official

Name
Crystal Macneill
Title
VP, Cbo Director
Phone
(646) 605-8112

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207P00000X NY Primary

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 1

  • FPA Urgent Care Center Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
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

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 315

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 315

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "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

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 7, 2015; 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.

Verify at the official NPI Registry.