Individual provider Active NPI

Paul Ralph Augustin, MD

  • Family Medicine Physician
  • New York, NY
National Provider Identifier
1184838831
Registry record updated May 13, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
249267 Issued in NY
Practice address
163 West 125TH Street
MPC 125TH Street Clinic,
New York, NY 10027
Phone
(212) 866-2751
Fax
(212) 866-2760
NPI assigned
May 10, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 13, 2009

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 57010945 OH
Family Medicine Physician 207Q00000X 249267 NY Primary

Addresses

Primary practice location

163 West 125TH Street
MPC 125TH Street Clinic,
New York, NY 10027

Mailing address

3057 Nassau Rd
Oceanside, NY 11572-3040
Phone (347) 414-0355

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
I20111212000391 NY Practitioner - Family Practice 7113192675 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 1995
Medicare assignment
May accept Medicare assignment
Telehealth
Offers telehealth services
Group practices
Montefiore Medical CenterGroup PAC ID 3779496021, 2,809 clinicians

Practice addresses (Care Compare)

111 E 210TH St
Bronx, NY 10467-2401
Phone (718) 920-4321

Hospital & facility affiliations

  • Montefiore Medical Center Hospital, Bronx, NY, CCN 330059

Merit-based Incentive Payment System (MIPS)

Final score
100 of 100Reported as group
Promoting interoperability
100
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
249267NYMDFamily Medicine Physician
57010945OHMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Montefiore Medical Center CurrentSince Mar 15, 2015 Accepting new patients
Montefiore Medical Center CurrentSince Mar 15, 2015 Accepting new patients

Locations

2300 Westchester Ave
Bronx, NY 10462
Phone (718) 409-8000

111 E 210th St
Bronx, NY 10467

2100 Bartow Ave
Bronx, NY 10475
Phone (718) 320-5300

Networks

  • Healthfirst Medicare Network H3359
  • Healthfirst Medicare Network H5989
  • Healthfirst Medicare Network H9678
  • 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 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": "1178755200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1242172800000",
    "number": "1184838831",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3057 NASSAU RD",
            "city": "OCEANSIDE",
            "state": "NY",
            "postal_code": "115723040",
            "telephone_number": "347-414-0355"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "163 WEST 125TH STREET",
            "address_2": "MPC 125TH STREET CLINIC,",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "10027",
            "telephone_number": "212-866-2751",
            "fax_number": "212-866-2760"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "AUGUSTIN",
        "first_name": "PAUL",
        "middle_name": "RALPH",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-05-10",
        "last_updated": "2009-05-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "OH",
            "license": "57010945",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NY",
            "license": "249267",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

Verify at the official NPI Registry.