Individual provider Active NPI

Serife Eti, MD

  • Family Medicine Physician
  • Ny, NY
National Provider Identifier
1255401451
Registry record updated Jan 18, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
229112 Issued in NY
Practice address
330 E 17TH St
Ny, NY 10003
Phone
(212) 844-1505
Fax
(212) 844-1503
NPI assigned
Nov 8, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 18, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 229112 NY Primary

Addresses

Primary practice location

330 E 17TH St
Ny, NY 10003

Mailing address

PO Box 95000-2435
Philadelphia, PA 19195-2435
Phone (914) 231-6806

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
I20040430000573 NY Practitioner - Hospice/Palliative Care 1052308996 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Hospice/Palliative Care
Education
Other, 1985
Medicare assignment
May accept Medicare assignment
Telehealth
Offers telehealth services
Group practices
Montefiore Medical CenterGroup PAC ID 3779496021, 2,809 clinicians

Practice addresses (Care Compare)

111 E 210TH St
Bronx, NY 10467-2401
Phone (718) 920-4321

Hospital & facility affiliations

  • Montefiore Medical Center Hospital, Bronx, NY, CCN 330059

Merit-based Incentive Payment System (MIPS)

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

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
229112NYMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Comprehensive Pain Management-Anesthesia Services, P.C. CurrentSince Jul 4, 2010 Accepting new patients
Montefiore Medical Center CurrentSince Jun 12, 2015 Accepting new patients
Montefiore Medical Center CurrentSince Jun 12, 2015 Accepting new patients
Montefiore Medical Center Past Accepting new patients
Montefiore Medical Center Past Accepting new patients

Locations

111 E 210th St
Bronx, NY 10467

3347 Steuben Ave
Bronx, NY 10467

1055 E Tremont Ave
Bronx, NY 10460
Phone (718) 842-8040

10 Union Sq E
#4K
New York, NY 10003
Phone (212) 844-1502

Networks

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

Interoperability endpoints

  • FHIR API: https://fhir.fhirpoint.open.allscripts.com/fhirroute/open/77186
  • FHIR API: https://fhir4.healow.com/fhir/r4/BHHDBA

Organizations & group practices 5

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.

Hospital & facility affiliations 1

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": "1162944000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1358467200000",
    "number": "1255401451",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 95000-2435",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191952435",
            "telephone_number": "914-231-6806"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "330 E 17TH ST",
            "city": "NY",
            "state": "NY",
            "postal_code": "10003",
            "telephone_number": "212-844-1505",
            "fax_number": "212-844-1503"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ETI",
        "first_name": "SERIFE",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-11-08",
        "last_updated": "2013-01-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NY",
            "license": "229112",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ny, NY

Sources for this page

Verify at the official NPI Registry.