Organization Active NPI

Private Medical Group of New Rochelle

  • Internal Medicine Physician
  • New Rochelle, NY
National Provider Identifier
1154439941
Registry record updated Jun 5, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
Legal business name
PRIVATE MEDICAL GROUP OF NEW ROCHELLE
Practice address
150 Lockwood Ave
Suite 32
New Rochelle, NY 10801
Phone
(914) 632-1235
NPI assigned
Aug 29, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 5, 2014

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

Authorized official

Name
Dr. James R Mussman, MDNPI 1346219615
Title
Physician
Phone
(914) 632-1235

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207R00000X Primary

Addresses

Primary practice location

150 Lockwood Ave
Suite 32
New Rochelle, NY 10801

Mailing address

150 Lockwood Ave
Suite 32
New Rochelle, NY 10801
Phone (914) 632-1235

Other identifiers 1

IdentifierTypeStateIssuer
00524272MedicaidNY

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040412000144 NY Part B Supplier - Clinic/Group Practice 2163324443 Receives reassigned benefits from 1 practitioner
Practice locations: New Rochelle, NY

National Provider Directory

National Provider Directory

Locations

150 Lockwood Ave
Ste 32
New Rochelle, NY 10801
Phone (914) 363-3232

Practitioners & affiliated clinicians

Practitioners 1

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

NPI Registry JSON

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

{
    "created_epoch": "1156809600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1401926400000",
    "number": "1154439941",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "150 LOCKWOOD AVE",
            "address_2": "SUITE 32",
            "city": "NEW ROCHELLE",
            "state": "NY",
            "postal_code": "10801",
            "telephone_number": "914-632-1235"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "150 LOCKWOOD AVE",
            "address_2": "SUITE 32",
            "city": "NEW ROCHELLE",
            "state": "NY",
            "postal_code": "10801",
            "telephone_number": "914-632-1235"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PRIVATE MEDICAL GROUP OF NEW ROCHELLE",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-29",
        "last_updated": "2014-06-05",
        "status": "A",
        "authorized_official_last_name": "MUSSMAN",
        "authorized_official_first_name": "JAMES",
        "authorized_official_middle_name": "R",
        "authorized_official_title_or_position": "PHYSICIAN",
        "authorized_official_telephone_number": "914-632-1235",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00524272",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in New Rochelle, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 5, 2014; 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.