NPIMap

Organization Active NPI

Icahn School of Medicine at Mount Sinai

Doing business as Mount Sinai Brooklyn Heights

  • Internal Medicine Physician
  • Brooklyn, NY
National Provider Identifier
1255719563
Registry record updated Jul 29, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
Legal business name
ICAHN SCHOOL OF MEDICINE AT MOUNT SINAI
Doing business as
Mount Sinai Brooklyn Heights
Practice address
300 Cadman Plaza West
Brooklyn, NY 11201
Phone
(929) 210-6000
Fax
(929) 210-6001
NPI assigned
May 7, 2015
Last updated
Jul 29, 2015By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 29, 2015

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

Authorized official

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

Specialties & licenses 14

Specialty (taxonomy)CodeLicenseStatePrimary
Podiatric Clinic/Center 261QP1100X NU
Allergy & Immunology Physician 207K00000X NU
Anesthesiology Physician 207L00000X NU
Pain Medicine (Anesthesiology) Physician 207LP2900X NU
Family Medicine Physician 207Q00000X NU
Internal Medicine Physician 207R00000X NU Primary
Obstetrics & Gynecology Physician 207V00000X NU
Ophthalmology Physician 207W00000X NU
Orthopaedic Surgery Physician 207X00000X NU
Pediatrics Physician 208000000X NU
Radiological Physics Physician 2085R0205X NU
Surgery Physician 208600000X NU
Urology Physician 208800000X NU
General Practice Physician 208D00000X NU

Addresses

Primary practice location

300 Cadman Plaza West
Brooklyn, NY 11201

Mailing address

150 East 42ND Street
10TH Floor
New York, NY 10017
Phone (646) 605-8119

Other names 1

  • Mount Sinai Brooklyn Heights Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20150917001387 NY Part B Supplier - Clinic/Group Practice 2264691070 Receives reassigned benefits from 109 practitioners
1 other NPI on this enrollment
Practice locations: Brooklyn, NY

Other NPIs on the same Medicare enrollment 1

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

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
33D2052306Icahn School of Medicine at Mount Sinai300 Cadman Plaza - 18TH Floor, Brooklyn, NY 11201Certificate of waiverMar 26, 2027

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 111

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 111

NPI Registry JSON

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

{
    "created_epoch": "1430956800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1438128000000",
    "number": "1255719563",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "150 EAST 42ND STREET",
            "address_2": "10TH FLOOR",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "10017",
            "telephone_number": "646-605-8119",
            "fax_number": "646-605-3029"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "300 CADMAN PLAZA WEST",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "11201",
            "telephone_number": "929-210-6000",
            "fax_number": "929-210-6001"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ICAHN SCHOOL OF MEDICINE AT MOUNT SINAI",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-05-07",
        "last_updated": "2015-07-29",
        "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",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "261QP1100X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Podiatric",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "207K00000X",
            "taxonomy_group": "",
            "desc": "Allergy & Immunology",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "207LP2900X",
            "taxonomy_group": "",
            "desc": "Anesthesiology, Pain Medicine",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "207X00000X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "2085R0205X",
            "taxonomy_group": "",
            "desc": "Radiology, Radiological Physics",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "208800000X",
            "taxonomy_group": "",
            "desc": "Urology",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Mount Sinai Brooklyn Heights",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Brooklyn, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 29, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.