Individual provider Active NPI

Carol Beverly Allen, M.D.

  • Internal Medicine Physician
  • Hartsdale, NY
National Provider Identifier
1164440772
Registry record updated Nov 8, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
145673 Issued in NY
Practice address
19 Beechwood Rd
Hartsdale, NY 10530-1623
Phone
(914) 288-0041
NPI assigned
Jul 18, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 8, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Endocrinology, Diabetes & Metabolism Physician 207RE0101X 145673 NY
Internal Medicine Physician 207R00000X 145673 NY Primary

Addresses

Primary practice location

19 Beechwood Rd
Hartsdale, NY 10530-1623

Mailing address

19 Beechwood Rd
Hartsdale, NY 10530-1623
Phone (914) 288-0041

Other identifiers 1

IdentifierTypeStateIssuer
03395791MedicaidNY

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
I20110111000778 NY Practitioner - Family PracticePractitioner - Internal MedicinePractitioner - Endocrinology 8729277405 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family PracticeAlso: Endocrinology
Education
Perelman School of Med at the University of Pennsylvania, 1979
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Mount Vernon Neighborhood Health Center IncGroup PAC ID 0345139671, 48 clinicians

Practice addresses (Care Compare)

107 W 4TH St
Mount Vernon, NY 10550-4002
Phone 9146997200660

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Mount Vernon Neighborhood Health Center Inc CurrentSince Dec 24, 2021 Accepting new patients
Mount Vernon Neighborhood Health Center, Inc. CurrentSince Dec 24, 2021 Accepting new patients

Locations

107 W 4th St
Mount Vernon, NY 10550
Phone (914) 699-0235

295 Knollwood Rd
White Plains, NY 10607
Phone (914) 699-7200

Networks

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

Interoperability endpoints

  • FHIR API: https://fhir-api.fhirprod.aws.greenwayhealth.com/fhir/R4/2.16.840.1.113883.3.140.71482

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": "1153180800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1636329600000",
    "number": "1164440772",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "19 BEECHWOOD RD",
            "city": "HARTSDALE",
            "state": "NY",
            "postal_code": "105301623",
            "telephone_number": "914-288-0041",
            "fax_number": "914-288-0041"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "19 BEECHWOOD RD",
            "city": "HARTSDALE",
            "state": "NY",
            "postal_code": "105301623",
            "telephone_number": "914-288-0041"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ALLEN",
        "first_name": "CAROL",
        "middle_name": "BEVERLY",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-18",
        "last_updated": "2021-11-08",
        "certification_date": "2021-11-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RE0101X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Endocrinology, Diabetes & Metabolism",
            "state": "NY",
            "license": "145673",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NY",
            "license": "145673",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "03395791",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Hartsdale, NY

Sources for this page

Verify at the official NPI Registry.