NPIMap

Organization Active NPI

Icahn School of Medicine at Mount Sinai

Doing business as Endocrinology Division of Mount Sinai

  • Endocrinology, Diabetes & Metabolism Physician
  • New York, NY
National Provider Identifier
1235490277
Registry record updated Jun 24, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Endocrinology, Diabetes & Metabolism PhysicianTaxonomy code 207RE0101X
Legal business name
ICAHN SCHOOL OF MEDICINE AT MOUNT SINAI
Doing business as
Endocrinology Division of Mount Sinai
Practice address
1 Gustave L Levy PL
New York, NY 10029-6574
Phone
(212) 987-3100
Fax
(212) 731-5220
NPI assigned
Jun 6, 2012
Last updated
Jun 24, 2015By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 24, 2015

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

Authorized official

Name
Crystal Macneill
Title
Vice President, Cbo Director
Phone
(646) 605-8112

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Endocrinology, Diabetes & Metabolism PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207RE0101X Primary

Addresses

Primary practice location

1 Gustave L Levy PL
New York, NY 10029-6574

Mailing address

PO Box 28082
New York, NY 10087-8082
Phone (212) 987-3100

Other names 1

  • Endocrinology Division of Mount Sinai Doing business as

Medicare participation

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

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20121004000137 NY Part B Supplier - Clinic/Group Practice 2264691070 Receives reassigned benefits from 85 practitioners
Practice locations: New York, NY; Brooklyn, NY; Greenlawn, NY; Jackson Heights, NY; Manhasset, NY
O20140807001116 NY Part B Supplier - Clinic/Group Practice 2264691070 Receives reassigned benefits from 20 practitioners
Practice locations: Astoria, NY; Jackson Heights, NY

National Provider Directory

National Provider Directory

Locations

396 Old Country Rd
Carle Place, NY 11514

8211 37th Ave
Jackson Heights, NY 11372
Phone (646) 747-8091

5 E 98th St
Fl 11
New York, NY 10029
Phone (212) 241-4299

Practitioners & affiliated clinicians

Practitioners 89

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 89

NPI Registry JSON

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

{
    "created_epoch": "1338940800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1435104000000",
    "number": "1235490277",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 28082",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100878082",
            "telephone_number": "212-987-3100",
            "fax_number": "212-731-5220"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 GUSTAVE L LEVY PL",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100296574",
            "telephone_number": "212-987-3100",
            "fax_number": "212-731-5220"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ICAHN SCHOOL OF MEDICINE AT MOUNT SINAI",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-06-06",
        "last_updated": "2015-06-24",
        "status": "A",
        "authorized_official_last_name": "MACNEILL",
        "authorized_official_first_name": "CRYSTAL",
        "authorized_official_title_or_position": "VICE PRESIDENT, CBO DIRECTOR",
        "authorized_official_telephone_number": "646-605-8112"
    },
    "taxonomies": [
        {
            "code": "207RE0101X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine, Endocrinology, Diabetes & Metabolism",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Endocrinology Division of Mount Sinai",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in New York, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 24, 2015; 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.