NPIMap

Organization Active NPI

Montefiore Medical Center

Doing business as Montefiore Community Pharmacy @ CHAM

  • Community/Retail Pharmacy
  • Bronx, NY
National Provider Identifier
1194183715
Registry record updated Sep 21, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Retail PharmacyTaxonomy code 3336C0003X
License
034452 Issued in NY
Legal business name
MONTEFIORE MEDICAL CENTER
Doing business as
Montefiore Community Pharmacy @ CHAM
Practice address
111 E 210TH St
Bronx, NY 10467-2401
Phone
(718) 484-5160
NPI assigned
Feb 10, 2016
Last updated
Sep 21, 2016By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 21, 2016

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

Authorized official

Name
Steven TuckmanNPI 1811011240
Title
Manager
Phone
(718) 920-5194

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacy 333600000X
Clinic Pharmacy 3336C0002X
Community/Retail Pharmacy 3336C0003X 034452 NY Primary

Addresses

Primary practice location

111 E 210TH St
Bronx, NY 10467-2401

Mailing address

111 E 210TH St
Bronx, NY 10467-2401
Phone (718) 484-5160

Other identifiers 1

IdentifierTypeStateIssuer
2162482OtherPK

Other names 1

  • Montefiore Community Pharmacy @ CHAM Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20171204002068 NY DME Supplier - Pharmacy 3779496021 Practice locations: Bronx, NY
O20240206002878 NY Part B Supplier - Pharmacy 3779496021 2 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Bronx, NY; Yonkers, NY

Other NPIs with the same Medicare PAC ID 16

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

View all 16

Other NPIs on the same Medicare enrollment 2

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory
Tax ID family
MMC at Icahn House Family Shelter520 organizations share this tax ID, including this one

Organizations with this tax ID in the same state 24

This tax ID family is large, so up to 24 of its organizations in the same state are linked here.

View all 24

Locations (25 of 34)

400 Franklin Tpke
Ste 202
Mahwah, NJ 07430
Phone (201) 236-3622

111 E 210th St
#2
Bronx, NY 10467
Phone (718) 920-6721

111 E 210th St
#6
Bronx, NY 10467
Phone (718) 920-4846

1250 Waters Pl
Ste 501A
Bronx, NY 10461
Phone (718) 409-9444

1515 Blondell Ave
Ste 220
Bronx, NY 10461
Phone (718) 405-8140

1625 Poplar St
Bronx, NY 10461
Phone (718) 405-8440

2005 Jerome Ave
Bronx, NY 10453
Phone (718) 583-0600

2058 Jerome Ave
Bronx, NY 10453
Phone (917) 564-8700

2532 Grand Concourse
Bronx, NY 10458
Phone (718) 960-1500

3000 E Tremont Ave
Bronx, NY 10461
Phone (718) 430-6375

3010 Briggs Ave
Bronx, NY 10458
Phone (718) 563-5263

3201 Grand Concourse
Apt 1J
Bronx, NY 10468
Phone (718) 933-2244

3219 E Tremont Ave
#1
Bronx, NY 10461
Phone (718) 792-8115

3314 Steuben Ave
Bronx, NY 10467
Phone (718) 920-5833

3444 Kossuth Ave
Fl 1
Bronx, NY 10467
Phone (718) 860-8440

3549 Webster Ave
Uppr
Bronx, NY 10467

3549 Webster Ave
Uppr FLO0R
Bronx, NY 10467

360 E 193rd St
#2
Bronx, NY 10458

3736 Henry Hudson Pkwy
Rear 1
Bronx, NY 10463
Phone (718) 920-4320

450 Saint Pauls Pl
Bronx, NY 10456
Phone (718) 588-3766

701 Saint Anns Ave
Bronx, NY 10455
Phone (718) 402-7618

853 Longwood Ave
Ste 201
Bronx, NY 10459
Phone (212) 535-9779

27 Smith St
Brooklyn, NY 11201
Phone (718) 488-0001

1874 Route 6
Carmel, NY 10512
Phone (845) 704-8331

45 Knollwood Rd
Elmsford, NY 10523
Phone (914) 345-8408

Practitioners & affiliated clinicians

Practitioners 5,935

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 5,935

NPI Registry JSON

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

{
    "created_epoch": "1455062400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1474416000000",
    "number": "1194183715",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "111 E 210TH ST",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "104672401",
            "telephone_number": "718-484-5160"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "111 E 210TH ST",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "104672401",
            "telephone_number": "718-484-5160"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MONTEFIORE MEDICAL CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-02-10",
        "last_updated": "2016-09-21",
        "status": "A",
        "authorized_official_last_name": "TUCKMAN",
        "authorized_official_first_name": "STEVEN",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "718-920-5194"
    },
    "taxonomies": [
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336C0002X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Clinic Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "NY",
            "license": "034452",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2162482",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Montefiore Community Pharmacy @ CHAM",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Bronx, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 21, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.