Individual provider Active NPI

Patricia M McQuade-Koors, MD

  • Pediatrics Physician
  • Bronx, NY
National Provider Identifier
1235214693
Registry record updated Feb 11, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
118464 Issued in NY
Practice address
MMG - Map
3400 Bainbridge Avenue
Bronx, NY 10467
Phone
(718) 920-8888
NPI assigned
Oct 26, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 11, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 118464 NY Primary

Addresses

Primary practice location

MMG - Map
3400 Bainbridge Avenue
Bronx, NY 10467

Mailing address

3400 Bainbridge Ave
Bronx, NY 10467-2404
Phone (718) 920-8888

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
I20071126000395 NY Practitioner - Pediatric Medicine 8729176821 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
118464NYMDSocial Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Montefiore Medical Center Pediatrics CurrentSince Jan 1, 2012 Accepting new patients
Montefiore Medical Center CurrentSince Jan 1, 2012 Accepting new patients

Locations

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

111 E 210th St
Bronx, NY 10467

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.

NPI Registry JSON

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

{
    "created_epoch": "1161820800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1265846400000",
    "number": "1235214693",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3400 BAINBRIDGE AVE",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "104672404",
            "telephone_number": "718-920-8888",
            "fax_number": "718-519-1164"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "MMG - MAP",
            "address_2": "3400 BAINBRIDGE AVENUE",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "10467",
            "telephone_number": "718-920-8888"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCQUADE-KOORS",
        "first_name": "PATRICIA",
        "middle_name": "M",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-26",
        "last_updated": "2010-02-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "NY",
            "license": "118464",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bronx, NY

Sources for this page

Verify at the official NPI Registry.