NPIMap

Individual provider Active NPI

Dmitry Shtrambrand, MD

  • Internal Medicine Physician
  • West Nyack, NY
National Provider Identifier
1174578165
Registry record updated Feb 7, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
252395 Issued in NY
Practice address
2 Crosfield Ave
Suite 318
West Nyack, NY 10994-2226
Phone
(845) 353-5600
Fax
(845) 353-3474
NPI assigned
May 24, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 7, 2013

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 25MA07719100 NJ
Internal Medicine Physician 207R00000X 252395 NY Primary

Addresses

Primary practice location

2 Crosfield Ave
Suite 318
West Nyack, NY 10994-2226

Mailing address

PO Box 843398
Boston, MA 02284-3398
Phone (845) 353-5600

Other identifiers 2

IdentifierTypeStateIssuer
0048372MedicaidNJ
1174578165OtherNPI

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20090910000271 NY Practitioner - Internal Medicine 8820051303 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
State University of New York Downstate Medical Center, 2001
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Bon Secours Charity Health System Medical Group, P.C.Group PAC ID 1658262084, 157 clinicians

Practice addresses (Care Compare)

2 Crosfield Ave
West Nyack, NY 10994-2226
Phone (845) 353-5600

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
96.73 of 100Reported as apm
Quality
87.82
Promoting interoperability
92
Improvement activities
40

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Bon Secours Charity Health System Medical Group, P.C. Internal Medicine CurrentSince Jan 1, 2013 Accepting new patients
Evergreen Physicians of North Jersey, PC Internal Medicine PastSince Dec 8, 2006 Accepting new patients

Locations

20 Grand St
Fl 3
Warwick, NY 10990
Phone (845) 987-3901

2 Crosfield Ave
West Nyack, NY 10994
Phone (212) 725-8511

2 Crosfield Ave
Ste 318
West Nyack, NY 10994
Phone (845) 353-5600

Networks

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

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.

Hospital & facility affiliations 5

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": "1148428800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1360195200000",
    "number": "1174578165",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 843398",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "022843398",
            "telephone_number": "845-353-5600",
            "fax_number": "845-353-3474"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2 CROSFIELD AVE",
            "address_2": "SUITE 318",
            "city": "WEST NYACK",
            "state": "NY",
            "postal_code": "109942226",
            "telephone_number": "845-353-5600",
            "fax_number": "845-353-3474"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHTRAMBRAND",
        "first_name": "DMITRY",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-05-24",
        "last_updated": "2013-02-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NJ",
            "license": "25MA07719100",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NY",
            "license": "252395",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0048372",
            "state": "NJ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI",
            "identifier": "1174578165",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in West Nyack, NY

Sources for this page

Verify at the official NPI Registry.