Organization Active NPI

Weill Medical College of Cornell

  • Cardiovascular Disease Physician
  • New York, NY
National Provider Identifier
1144729385
Registry record updated Feb 2, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Cardiovascular Disease PhysicianTaxonomy code 207RC0000X
Legal business name
WEILL MEDICAL COLLEGE OF CORNELL
Practice address
520 E 70TH St # ST4
New York, NY 10021-9800
Phone
(646) 962-5558
NPI assigned
Feb 2, 2018
Last updated
Feb 2, 2018By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 2, 2018

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

Authorized official

Name
Fabiane De Souza
Title
Enrollment Coordinator
Phone
(646) 962-2543

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Cardiovascular Disease Physician 207RC0000X Primary

Addresses

Primary practice location

520 E 70TH St # ST4
New York, NY 10021-9800

Mailing address

575 Lexington Ave RM 540
New York, NY 10022-6145
Phone (646) 962-2543

Other names 1

  • Adult Congenital Heart Disease Other name

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20180711001946 NY Part B Supplier - Clinic/Group Practice 6800709023 Receives reassigned benefits from 5 practitioners
Practice locations: New York, NY; Brooklyn, NY

National Provider Directory

National Provider Directory

Locations

1957 Westchester Ave
Bronx, NY 10462
Phone (347) 851-6633

2960 Ocean Ave
Ste 6
Brooklyn, NY 11235
Phone (646) 382-7742

55 Greene Ave
Ste Llb
Brooklyn, NY 11238
Phone (718) 789-5900

4604 31st Ave
Ofc 1
Long Island City, NY 11103
Phone (347) 808-7200

933 Mamaroneck Ave
Mamaroneck, NY 10543
Phone (914) 698-2056

1305 York Ave
#12
New York, NY 10021
Phone (646) 962-6200

1305 York Ave
#5
New York, NY 10021
Phone (212) 746-2281

1305 York Ave
Ste 11
New York, NY 10021
Phone (646) 962-2020

1305 York Ave
Ste 12
New York, NY 10021
Phone (646) 962-6200

156 William St
Lowr
New York, NY 10038
Phone (646) 962-3686

254 W 10th St
New York, NY 10014
Phone (212) 627-2270

41 Elizabeth St
New York, NY 10013
Phone (212) 219-0534

41 Elizabeth St
Ste 507
New York, NY 10013
Phone (212) 966-8890

413 E 69th St
New York, NY 10021
Phone (410) 458-4717

425 E 61st St
#5
New York, NY 10065
Phone (646) 962-7378

425 E 61st St
Ste 8
New York, NY 10065
Phone (212) 746-0923

428 E 72nd St
Ofc 600
New York, NY 10021
Phone (212) 746-4371

525 E 68th St
#2109
New York, NY 10065
Phone (212) 746-5196

525 E 68th St
#F734
New York, NY 10065
Phone (212) 746-5593

525 E 68th St
#F818W
New York, NY 10065
Phone (212) 746-2484

525 E 68th St
Rm J314
New York, NY 10065
Phone (212) 746-4158

530 E 70th St
New York, NY 10021
Phone (212) 746-4720

575 E 68th St
New York, NY 10065
Phone (646) 962-2012

G Po 29886
New York, NY 10087

2381 Hylan Blvd
Ste Ah
Staten Island, NY 10306
Phone (718) 967-6696

Practitioners & affiliated clinicians

Practitioners 3,452

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 3,452

NPI Registry JSON

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

{
    "created_epoch": "1517529600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1517529600000",
    "number": "1144729385",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "575 LEXINGTON AVE RM 540",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100226145",
            "telephone_number": "646-962-2543"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "520 E 70TH ST # ST4",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100219800",
            "telephone_number": "646-962-5558"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WEILL MEDICAL COLLEGE OF CORNELL",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-02-02",
        "last_updated": "2018-02-02",
        "status": "A",
        "authorized_official_last_name": "DE SOUZA",
        "authorized_official_first_name": "FABIANE",
        "authorized_official_title_or_position": "ENROLLMENT COORDINATOR",
        "authorized_official_telephone_number": "646-962-2543"
    },
    "taxonomies": [
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Adult Congenital Heart Disease",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

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 Feb 2, 2018; 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.