Organization Active NPI

Methuselah Medical Services PLLC

  • Primary Care Clinic/Center
  • New Rochelle, NY
National Provider Identifier
1205167384
Registry record updated Jan 29, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Primary Care Clinic/CenterTaxonomy code 261QP2300X
Legal business name
METHUSELAH MEDICAL SERVICES PLLC
Practice address
25 Coligni Ave
New Rochelle, NY 10801-2605
Phone
(914) 636-1967
Fax
(914) 636-6083
NPI assigned
Jan 29, 2010
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 29, 2010

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

Authorized official

Name
Dr. Ralph Essien, MDNPI 1679668370
Title
President
Phone
(914) 636-1967

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Primary Care Clinic/Center 261QP2300X Primary

Addresses

Primary practice location

25 Coligni Ave
New Rochelle, NY 10801-2605

Mailing address

25 Coligni Ave
New Rochelle, NY 10801-2605
Phone (914) 636-1967

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20111228000553 NY Part B Supplier - Clinic/Group Practice 2860668654 Receives reassigned benefits from 1 practitioner
Practice locations: New Rochelle, NY

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
33D0954125Methuselah Medical Services25 Coligni Avenue, New Rochelle, NY 10801Certificate of waiverNov 17, 2026

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1264723200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1264723200000",
    "number": "1205167384",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "25 COLIGNI AVE",
            "city": "NEW ROCHELLE",
            "state": "NY",
            "postal_code": "108012605",
            "telephone_number": "914-636-1967",
            "fax_number": "914-636-6083"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "25 COLIGNI AVE",
            "city": "NEW ROCHELLE",
            "state": "NY",
            "postal_code": "108012605",
            "telephone_number": "914-636-1967",
            "fax_number": "914-636-6083"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "METHUSELAH MEDICAL SERVICES PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-01-29",
        "last_updated": "2010-01-29",
        "status": "A",
        "authorized_official_last_name": "ESSIEN",
        "authorized_official_first_name": "RALPH",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "914-636-1967",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New Rochelle, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 29, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.