Individual provider Active NPI

Ian L Baine, M.D., PH.D

  • Clinical Pathology Physician
  • New York, NY
National Provider Identifier
1154732584
Registry record updated Aug 21, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Pathology PhysicianTaxonomy code 207ZC0006X
License
297435 Issued in NY
Practice address
1470 Madison Ave
New York, NY 10029-6542
Phone
(122) 241-5486
NPI assigned
May 20, 2014
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 21, 2019

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Molecular Genetic Pathology (Pathology) Physician 207ZP0007X 297435 NY
Clinical Pathology Physician 207ZC0006X 297435 NY Primary

Addresses

Primary practice location

1470 Madison Ave
New York, NY 10029-6542

Mailing address

310 Cedar St
Yale Univ. School of Medicine Department of Pathology
New Haven, CT 06520-8070
Phone (203) 737-2115

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20191014000355 NY Practitioner - Pathology 0648501247 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Pathology
Education
Albert Einstein College of Medicine of Yeshiva University, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Icahn School of Medicine at Mount SinaiGroup PAC ID 2264691070, 2,809 clinicians

Practice addresses (Care Compare)

1 Gustave L Levy PL
New York, NY 10029-6504
Phone (212) 241-8014

Hospital & facility affiliations

  • Mount Sinai Hospital Hospital, New York, NY, CCN 330024

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
297435NYMDClinical Pathology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Fpa Hospital Based Molecular Genetic Pathology CurrentSince Aug 14, 2019 Accepting new patients
Icahn School of Medicine at Mount Sinai CurrentSince Apr 1, 2023 Accepting new patients
Fpa Hospital Based Current Accepting new patients
Fpa Hospital Based CurrentSince Aug 14, 2019 Accepting new patients
Icahn School of Medicine at Mount Sinai CurrentSince Apr 1, 2023 Accepting new patients
Fpa Hospital Based Molecular Genetic Pathology Current Accepting new patients

Locations

4802 10th Ave
Brooklyn, NY 11219
Phone (718) 283-8724

1470 Madison Ave
New York, NY 10029
Phone (212) 241-0806

1468 Madison Ave
New York, NY 10029
Phone (212) 241-0440

5 E 98th St
Fl 6
New York, NY 10029
Phone (212) 241-2221

Networks

  • Healthfirst Medicare Network H9678
  • Healthfirst Medicare Network H3359
  • Healthfirst Medicare Network H5989
  • Healthfirst Medicare Network H1722

Organizations & group practices 6

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.

Hospital & facility affiliations 6

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1400544000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1566345600000",
    "number": "1154732584",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "310 CEDAR ST",
            "address_2": "YALE UNIV. SCHOOL OF MEDICINE DEPARTMENT OF PATHOLOGY",
            "city": "NEW HAVEN",
            "state": "CT",
            "postal_code": "065208070",
            "telephone_number": "203-737-2115"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1470 MADISON AVE",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100296542",
            "telephone_number": "122-241-5486"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BAINE",
        "first_name": "IAN",
        "middle_name": "L",
        "credential": "M.D., PH.D",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2014-05-20",
        "last_updated": "2019-08-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207ZP0007X",
            "taxonomy_group": "",
            "desc": "Pathology, Molecular Genetic Pathology",
            "state": "NY",
            "license": "297435",
            "primary": false
        },
        {
            "code": "207ZC0006X",
            "taxonomy_group": "",
            "desc": "Pathology, Clinical Pathology",
            "state": "NY",
            "license": "297435",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

Verify at the official NPI Registry.