Individual provider Active NPI

Leelamma Joseph, M.D.,

  • Internal Medicine Physician
  • New York, NY
National Provider Identifier
1154425171
Registry record updated Jun 2, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
240619 Issued in NY
Practice address
102 Rivers Edge Rd
New York, NY 10035-1163
Phone
(646) 672-6767
NPI assigned
Sep 11, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 2, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 240619 NY Primary

Addresses

Primary practice location

102 Rivers Edge Rd
New York, NY 10035-1163

Mailing address

600 East 125TH St
Wards Island
New York, NY 10035
Phone (646) 672-6767

Other practice location 1

600 E 125th St
New York, NY 10035-6000
Phone (646) 672-6767

Other practice location 2

140 Old Orangeburg Rd
Orangeburg, NY 10962-1157
Phone (845) 359-1000

Other identifiers 1

IdentifierTypeStateIssuer
03099209MedicaidNY

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Eligible to order & refer
  • Part B services: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
240619NYMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Franklin Hospital Past Accepting new patients
Westchester County Health Care Corporation Past Accepting new patients

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1157932800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1685664000000",
    "number": "1154425171",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "600 EAST 125TH ST",
            "address_2": "WARDS ISLAND",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "10035",
            "telephone_number": "646-672-6767"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "102 RIVERS EDGE RD",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100351163",
            "telephone_number": "646-672-6767"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "600 E 125th St",
            "address_purpose": "LOCATION",
            "city": "New York",
            "state": "NY",
            "postal_code": "100356000",
            "country_code": "US",
            "telephone_number": "646-672-6767",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "140 Old Orangeburg Rd",
            "address_purpose": "LOCATION",
            "city": "Orangeburg",
            "state": "NY",
            "postal_code": "109621157",
            "country_code": "US",
            "telephone_number": "845-359-1000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "JOSEPH",
        "first_name": "LEELAMMA",
        "name_prefix": "Dr.",
        "credential": "M.D.,",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-09-11",
        "last_updated": "2023-06-02",
        "certification_date": "2023-06-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NY",
            "license": "240619",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "03099209",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

Verify at the official NPI Registry.