NPIMap

Organization Active NPI

Bronxcare Health System

  • Internal Medicine Physician
  • Bronx, NY
National Provider Identifier
1245390855
Registry record updated Feb 6, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
Legal business name
BRONXCARE HEALTH SYSTEM
Practice address
1650 Grand Concourse
Bronx, NY 10457
Phone
(718) 901-8600
NPI assigned
Dec 12, 2006
Last updated
Feb 6, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 6, 2020

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

Authorized official

Name
Victor Demarco
Title
Cfo
Phone
(718) 901-8600

Specialties & licenses 15

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X
Nurse Practitioner 363L00000X
Emergency Medicine Physician 207P00000X
Family Medicine Physician 207Q00000X
Internal Medicine Physician 207R00000X Primary
Cardiovascular Disease Physician 207RC0000X
Endocrinology, Diabetes & Metabolism Physician 207RE0101X
Gastroenterology Physician 207RG0100X
Hematology & Oncology Physician 207RH0003X
Infectious Disease Physician 207RI0200X
Otolaryngology Physician 207Y00000X
Anatomic Pathology & Clinical Pathology Physician 207ZP0102X
Pediatrics Physician 208000000X
Neurology Physician 2084N0400X
Psychiatry Physician 2084P0800X

Addresses

Primary practice location

1650 Grand Concourse
Bronx, NY 10457

Mailing address

1276 Fulton Avenue
Room 208
Bronx, NY 10456
Phone (718) 901-8918

Other identifiers 1

IdentifierTypeStateIssuer
01744072MedicaidNY

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040526001082 NY Part B Supplier - Clinic/Group Practice 3870404429 Receives reassigned benefits from 833 practitioners
18 other NPIs on this enrollment
Practice locations: Bronx, NY; West Harrison, NY

Other NPIs with the same Medicare PAC ID 5

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

Other NPIs on the same Medicare enrollment 18

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

View all 18

National Provider Directory

National Provider Directory

Locations

1265 Franklin Ave
Fl 6
Bronx, NY 10456

1276 Fulton Ave
Bronx, NY 10456
Phone (718) 518-5000

1650 Grand Concourse
Fl 1
Bronx, NY 10457
Phone (718) 518-5340

1650 Grand Concourse
Fl 12
Bronx, NY 10457
Phone (718) 518-5222

1650 Selwyn Ave
#1
Bronx, NY 10457
Phone (718) 579-3940

1650 Selwyn Ave
Fl 1
Bronx, NY 10457

1650 Selwyn Ave
Fl 9
Bronx, NY 10457
Phone (718) 775-0656

1650 Selwyn Ave
Frnt 1
Bronx, NY 10457

2604 3rd Ave
Fl 5
Bronx, NY 10454
Phone (718) 838-1016

Practitioners & affiliated clinicians

Practitioners 858

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 858

NPI Registry JSON

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

{
    "created_epoch": "1165881600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1580947200000",
    "number": "1245390855",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1276 FULTON AVENUE",
            "address_2": "ROOM 208",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "10456",
            "telephone_number": "718-901-8918"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1650 GRAND CONCOURSE",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "10457",
            "telephone_number": "718-901-8600"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BRONXCARE HEALTH SYSTEM",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-12",
        "last_updated": "2020-02-06",
        "certification_date": "2020-02-06",
        "status": "A",
        "authorized_official_last_name": "DEMARCO",
        "authorized_official_first_name": "VICTOR",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "718-901-8600"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207RE0101X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Endocrinology, Diabetes & Metabolism",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207RG0100X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Gastroenterology",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207RH0003X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Hematology & Oncology",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207RI0200X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Infectious Disease",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207Y00000X",
            "taxonomy_group": "",
            "desc": "Otolaryngology",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207ZP0102X",
            "taxonomy_group": "",
            "desc": "Pathology, Anatomic Pathology & Clinical Pathology",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2084N0400X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01744072",
            "state": "NY"
        }
    ],
    "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 Feb 6, 2020; 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.