Organization Active NPI

Castle Hill Medical of New York, Inc.

  • Clinic/Center
  • Bronx, NY
National Provider Identifier
1205949997
Registry record updated Oct 12, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinic/CenterTaxonomy code 261Q00000X
Legal business name
CASTLE HILL MEDICAL OF NEW YORK, INC.
Practice address
920 Castle Hill Ave
Bronx, NY 10473-1320
Phone
(718) 824-0500
Fax
(718) 824-2373
NPI assigned
Aug 16, 2006
Last updated
Oct 12, 2016By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 12, 2016

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

Authorized official

Name
Mr. Sam Rahat-Mutqadir
Title
Ceo
Phone
(718) 824-0500

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinic/Center 261Q00000X Primary

Addresses

Primary practice location

920 Castle Hill Ave
Bronx, NY 10473-1320

Mailing address

920 Castle Hill Ave
Bronx, NY 10473-1320
Phone (718) 824-0500

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20070514000486 NY Part B Supplier - Clinic/Group Practice 6800993593 Receives reassigned benefits from 4 practitioners
Practice locations: Bronx, NY

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 6

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.

NPI Registry JSON

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

{
    "created_epoch": "1155686400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1476230400000",
    "number": "1205949997",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "920 CASTLE HILL AVE",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "104731320",
            "telephone_number": "718-824-0500",
            "fax_number": "718-824-2373"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "920 CASTLE HILL AVE",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "104731320",
            "telephone_number": "718-824-0500",
            "fax_number": "718-824-2373"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CASTLE HILL MEDICAL OF NEW YORK, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-16",
        "last_updated": "2016-10-12",
        "status": "A",
        "authorized_official_last_name": "RAHAT-MUTQADIR",
        "authorized_official_first_name": "SAM",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "718-824-0500",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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 Oct 12, 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.