Organization Active NPI

Pelham Bay Community Medical, PC

  • Internal Medicine Physician
  • Bronx, NY
National Provider Identifier
1154673630
Registry record updated Oct 23, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
Legal business name
PELHAM BAY COMMUNITY MEDICAL, PC
Practice address
3250 Westchester Ave RM 101
Bronx, NY 10461-4548
Phone
(718) 409-2762
Fax
(718) 863-4432
NPI assigned
Oct 9, 2012
Last updated
Oct 23, 2026By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 23, 2026

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

Authorized official

Name
Dr. Enrico D'Angelo, MDNPI 1316030364
Title
Medical Director
Phone
(718) 409-2762

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 Physician 207R00000X Primary

Addresses

Primary practice location

3250 Westchester Ave RM 101
Bronx, NY 10461-4548

Mailing address

3 Greenhouse Cir
Rye Brook, NY 10573-1907
Phone (914) 937-8810

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20140515000463 NY Part B Supplier - Clinic/Group Practice 6305069592 Receives reassigned benefits from 1 practitioner
Practice locations: Bronx, NY

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1349740800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1792713600000",
    "number": "1154673630",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3 GREENHOUSE CIR",
            "city": "RYE BROOK",
            "state": "NY",
            "postal_code": "105731907",
            "telephone_number": "914-937-8810",
            "fax_number": "914-863-4432"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3250 WESTCHESTER AVE RM 101",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "104614548",
            "telephone_number": "718-409-2762",
            "fax_number": "718-863-4432"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PELHAM BAY COMMUNITY MEDICAL, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-10-09",
        "last_updated": "2026-10-23",
        "certification_date": "2026-10-23",
        "status": "A",
        "authorized_official_last_name": "D'ANGELO",
        "authorized_official_first_name": "ENRICO",
        "authorized_official_title_or_position": "MEDICAL DIRECTOR",
        "authorized_official_telephone_number": "718-409-2762",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bronx, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 23, 2026; 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.