Individual provider Active NPI

Michele H Mokrzycki, MD, MS

  • Nephrology Physician
  • Bronx, NY
National Provider Identifier
1215048822
Registry record updated Dec 14, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nephrology PhysicianTaxonomy code 207RN0300X
License
189085 Issued in NY
Practice address
111 E 210TH St
Montefiore Medical Center
Bronx, NY 10467-2401
Phone
(718) 920-5442
Fax
(718) 652-8384
NPI assigned
Aug 31, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 14, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nephrology Physician 207RN0300X 189085 NY Primary

Addresses

Primary practice location

111 E 210TH St
Montefiore Medical Center
Bronx, NY 10467-2401

Mailing address

510 E 80TH St
Apt 11D
New York, NY 10075-0719
Phone (212) 423-0239

Other identifiers 1

IdentifierTypeStateIssuer
01399742MedicaidNY

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
I20040827000885 NY Practitioner - NephrologyPractitioner - Internal Medicine 2860467412 Reassigns benefits to 1 organization

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Montefiore Medical Center CurrentSince Jan 1, 2006 Accepting new patients
Montefiore Medical Center Nephrology CurrentSince Jan 1, 2006 Accepting new patients
Montefiore Mount Vernon Hospital Past Accepting new patients

Locations

111 E 210th St
Bronx, NY 10467

1825 Eastchester Rd
Bronx, NY 10461
Phone (718) 904-2000

111 E 210th St
#9
Bronx, NY 10467
Phone (718) 920-5442

3411 Wayne Ave
Ste 5H
Bronx, NY 10467

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1156982400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1323820800000",
    "number": "1215048822",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "510 E 80TH ST",
            "address_2": "APT 11D",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100750719",
            "telephone_number": "212-423-0239",
            "fax_number": "718-652-8384"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "111 E 210TH ST",
            "address_2": "MONTEFIORE MEDICAL CENTER",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "104672401",
            "telephone_number": "718-920-5442",
            "fax_number": "718-652-8384"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOKRZYCKI",
        "first_name": "MICHELE",
        "middle_name": "H",
        "name_prefix": "Dr.",
        "credential": "MD, MS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-31",
        "last_updated": "2011-12-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RN0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Nephrology",
            "state": "NY",
            "license": "189085",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01399742",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Bronx, NY

Sources for this page

Verify at the official NPI Registry.