Individual provider Active NPI

Ohm Ma, M.D.

  • Internal Medicine Physician
  • Staten Island, NY
National Provider Identifier
1164834164
Registry record updated Jan 2, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
289753 Issued in NY
Practice address
355 Bard Ave
Department of Medicine Villa BLDG 1St Floor
Staten Island, NY 10310-1664
Phone
(718) 818-2419
NPI assigned
May 24, 2014
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 2, 2018

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Internal Medicine Physician 207R00000X 289753 NY Primary

Addresses

Primary practice location

355 Bard Ave
Department of Medicine Villa BLDG 1St Floor
Staten Island, NY 10310-1664

Mailing address

355 Bard Ave
Department of Medicine Villa BLDG 1St Floor
Staten Island, NY 10310-1664
Phone (718) 818-2419

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
I20180417000663 NY Practitioner - Internal Medicine 9830452267 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 2002
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

7901 Broadway
Elmhurst, NY 11373-1329
Phone (718) 334-4952

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
289753NYMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Icahn School of Medicine at Mount Sinai Internal Medicine CurrentSince Feb 25, 2018 Accepting new patients
Icahn School of Medicine at Mount Sinai Current Accepting new patients
Icahn School of Medicine at Mount Sinai CurrentSince Feb 25, 2018 Accepting new patients

Locations

7901 Broadway
Rm A119
Elmhurst, NY 11373
Phone (718) 334-3915

Networks

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

Interoperability endpoints

  • Direct secure messaging: oma342492@nychhc.direct-ci.com

Organizations & group practices 3

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 1

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": "1400889600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1514851200000",
    "number": "1164834164",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "355 BARD AVE",
            "address_2": "DEPARTMENT OF MEDICINE VILLA BLDG 1ST FLOOR",
            "city": "STATEN ISLAND",
            "state": "NY",
            "postal_code": "103101664",
            "telephone_number": "718-818-2419"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "355 BARD AVE",
            "address_2": "DEPARTMENT OF MEDICINE VILLA BLDG 1ST FLOOR",
            "city": "STATEN ISLAND",
            "state": "NY",
            "postal_code": "103101664",
            "telephone_number": "718-818-2419"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MA",
        "first_name": "OHM",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-05-24",
        "last_updated": "2018-01-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NY",
            "license": "289753",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Staten Island, NY

Sources for this page

Verify at the official NPI Registry.