NPIMap

Individual provider Active NPI

Mitchell Stephen Fourman, MD, M.PHIL

  • Orthopaedic Surgery Physician
  • Bronx, NY
National Provider Identifier
1245644400
Registry record updated Aug 31, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthopaedic Surgery PhysicianTaxonomy code 207X00000X
License
282504 Issued in MA
Practice address
1250 Waters PL
Tower 1, 11TH Floor
Bronx, NY 10461
Phone
(631) 513-9369
NPI assigned
Jun 16, 2014
Last updated
Aug 31, 2022By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 31, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Orthopaedic Surgery Physician 207X00000X 282504 MA Primary

Addresses

Primary practice location

1250 Waters PL
Tower 1, 11TH Floor
Bronx, NY 10461

Mailing address

1250 Waters PL
Tower 1, 11TH Floor
Bronx, NY 10461
Phone (631) 513-9369

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA, NY2 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20190524001621 PA Practitioner - Orthopedic Surgery 9133462625 Reassigns benefits to 1 organization
I20220929000715 NY Practitioner - Orthopedic Surgery 9133462625 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Orthopedic Surgery
Education
State University of New York at Stony Brook, School of Medicine, 2014
Medicare assignment
May accept Medicare assignment
Telehealth
Offers telehealth services
Group practices
SBH Physicians PCGroup PAC ID 3072798941, 178 clinicians
Montefiore Medical CenterGroup PAC ID 3779496021, 2,809 clinicians

Practice addresses (Care Compare)

111 E 210TH St
Bronx, NY 10467-2401
Phone (718) 960-6205

12 N 7TH Ave
Mount Vernon, NY 10550-2026
Phone (914) 378-6148

16 Guion PL
New Rochelle, NY 10801-5502
Phone (914) 378-6148

4422 3Rd Ave
Bronx, NY 10457-2545
Phone (718) 960-6214

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
100 of 100Reported as group
Promoting interoperability
100
Improvement activities
40

Procedures performed for Medicare patients

ProcedureNumber of procedures
Spinal fusion179
Laminectomy or laminotomy (partial removal of spine bones)41
Removal of tissue1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
308606NYMDAdult Psychiatric/Mental Health Registered Nurse
282504MAMDOrthopaedic Surgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Montefiore Medical Center Orthopaedic Surgery CurrentSince Aug 12, 2022 Accepting new patients
Montefiore Medical Center CurrentSince Aug 12, 2022 Accepting new patients
University of Pittsburgh Physicians CurrentSince Jul 1, 2019 Accepting new patients
University of Pittsburgh Physicians Current Accepting new patients
University of Pittsburgh Physicians Orthopaedic Surgery CurrentSince Jul 1, 2019 Accepting new patients
Montefiore New Rochelle Hospital Past Accepting new patients
Montefiore Medical Center Past Accepting new patients

Locations

111 E 210th St
Bronx, NY 10467

1250 Waters Pl
Fl 10
Bronx, NY 10461
Phone (347) 577-4484

1250 Waters Pl
Fl 11
Bronx, NY 10461
Phone (347) 577-4460

1250 Waters Pl
Fl 11
Bronx, NY 10461
Phone (347) 577-4410

555 Taxter Rd
Elmsford, NY 10523
Phone (718) 920-2587

12 N 7th Ave
Mount Vernon, NY 10550
Phone (914) 361-6511

101 Glover Johnson Pl
Fl 6
New Rochelle, NY 10801

3471 5th Ave
Ste 1010
Pittsburgh, PA 15213
Phone (412) 605-3254

3471 5th Ave
Ste 911
Pittsburgh, PA 15213
Phone (412) 605-3262

Networks

  • Healthfirst Medicare Network H5989
  • Healthfirst Medicare Network H1722
  • Healthfirst Medicare Network H9678
  • Healthfirst Medicare Network H3359

Interoperability endpoints

  • Direct secure messaging: mfourman@montefioredirect.com
  • Direct secure messaging: mfourman4580738@nychhc.direct-ci.com

Organizations & group practices 8

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 6

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1402876800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1661904000000",
    "number": "1245644400",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1250 WATERS PL",
            "address_2": "TOWER 1, 11TH FLOOR",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "10461",
            "telephone_number": "631-513-9369"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1250 WATERS PL",
            "address_2": "TOWER 1, 11TH FLOOR",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "10461",
            "telephone_number": "631-513-9369"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FOURMAN",
        "first_name": "MITCHELL",
        "middle_name": "STEPHEN",
        "name_prefix": "Dr.",
        "credential": "MD, M.PHIL",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-06-16",
        "last_updated": "2022-08-31",
        "certification_date": "2022-08-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207X00000X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery",
            "state": "MA",
            "license": "282504",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bronx, NY

Sources for this page

Verify at the official NPI Registry.