NPIMap

Organization Active NPI

Icahn School of Medicine at Mount Sinai

  • Obstetrics & Gynecology Physician
  • Oceanside, NY
National Provider Identifier
1154813350
Registry record updated Jun 16, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X
Legal business name
ICAHN SCHOOL OF MEDICINE AT MOUNT SINAI
Practice address
196 Merrick Rd
Oceanside, NY 11572
Phone
(516) 255-8400
NPI assigned
Jun 4, 2018
Last updated
Jun 16, 2018By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 16, 2018

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

Authorized official

Name
Alicia Gresham
Title
VP of Network Operations
Phone
(212) 659-9038

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 207Q00000X
Obstetrics & Gynecology PhysicianGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 207V00000X Primary
Obstetrics PhysicianGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 207VX0000X
Physician AssistantGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 363A00000X

Addresses

Primary practice location

196 Merrick Rd
Oceanside, NY 11572

Mailing address

1 Healthy Way
Oceanside, NY 11572-1551

Other practice location 1

2900 Hempstead Tpke Ste 203
Levittown, NY 11756-1401
Phone (516) 227-3333

Other practice location 2

1 Healthy Way
Oceanside, NY 11572-1551
Phone (877) 768-8462

Other practice location 3

2965 Long Beach Rd
Oceanside, NY 11572-3255
Phone (516) 763-7820

Other names 2

  • MOUNT SINAI DOCTORS SOUTH NASSAU - OB/GYN Other name
  • MOUNT SINAI DOCTORS SOUTH NASSAU-OB/GYN Other name

National Provider Directory

National Provider Directory
Tax ID family
Icahn School of Medicine at Mount Sinai8 organizations share this tax ID, including this one

Other organizations with this tax ID 7

Organizations that report the same tax identification number in the National Provider Directory.

NPI Registry JSON

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

{
    "created_epoch": "1528070400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1529107200000",
    "number": "1154813350",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 HEALTHY WAY",
            "city": "OCEANSIDE",
            "state": "NY",
            "postal_code": "115721551"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "196 MERRICK RD",
            "city": "OCEANSIDE",
            "state": "NY",
            "postal_code": "11572",
            "telephone_number": "516-255-8400"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2900 Hempstead Tpke Ste 203",
            "address_purpose": "LOCATION",
            "city": "Levittown",
            "state": "NY",
            "postal_code": "117561401",
            "country_code": "US",
            "telephone_number": "516-227-3333",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1 Healthy Way",
            "address_purpose": "LOCATION",
            "city": "Oceanside",
            "state": "NY",
            "postal_code": "115721551",
            "country_code": "US",
            "telephone_number": "877-768-8462",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2965 Long Beach Rd",
            "address_purpose": "LOCATION",
            "city": "Oceanside",
            "state": "NY",
            "postal_code": "115723255",
            "country_code": "US",
            "telephone_number": "516-763-7820",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "ICAHN SCHOOL OF MEDICINE AT MOUNT SINAI",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-06-04",
        "last_updated": "2018-06-16",
        "status": "A",
        "authorized_official_last_name": "GRESHAM",
        "authorized_official_first_name": "ALICIA",
        "authorized_official_title_or_position": "VP OF NETWORK OPERATIONS",
        "authorized_official_telephone_number": "212-659-9038"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207V00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Obstetrics & Gynecology",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "207VX0000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Obstetrics & Gynecology, Obstetrics",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "MOUNT SINAI DOCTORS SOUTH NASSAU - OB/GYN",
            "code": "5",
            "type": "Other Name"
        },
        {
            "organization_name": "MOUNT SINAI DOCTORS SOUTH NASSAU-OB/GYN",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Oceanside, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 16, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.