Organization Active NPI

Santa Isabel Pharmacy Inc

  • Community/Retail Pharmacy
  • New York, NY
National Provider Identifier
1265701957
Registry record updated Oct 30, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Retail PharmacyTaxonomy code 3336C0003X
License
030989 Issued in NY
Legal business name
SANTA ISABEL PHARMACY INC
Doing business as
santa isabel pharmacy inc
Practice address
145 Sherman Ave
New York, NY 10034-4604
Phone
(212) 567-1444
Fax
(212) 567-1448
NPI assigned
Dec 25, 2011
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 30, 2014

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

Authorized official

Name
Clara Leon
Title
President
Phone
(212) 567-1444

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Retail Pharmacy 3336C0003X 030989 NY Primary

Addresses

Primary practice location

145 Sherman Ave
New York, NY 10034-4604

Mailing address

145 Sherman Ave
New York, NY 10034-4604
Phone (212) 567-1444

Other identifiers 2

IdentifierTypeStateIssuer
2133339OtherPK
3591242MedicaidNY

Other names 1

  • santa isabel pharmacy inc Doing business as

Medicare participation

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

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20131118000532 NY DME Supplier - Pharmacy 5597991778 Practice locations: New York, NY
O20250501000233 NY Part B Supplier - Mass Immunization (Roster Biller Only) 5597991778 Practice locations: New York, NY

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.

Medicare medical equipment & supply locations

SupplierSuppliesMedicare assignment
Santa Isabel Pharmacy Inc.145 Sherman Ave, New York, NY 10034-4604(212) 567-1444 Epoetin|Immunosuppressive Drugs|Infusion Drugs|Nebulizer Drugs|Oral Anticancer Drugs|Oral Antiemetic Drugs Does not accept assignmentParticipating since May 28, 2013

National Provider Directory

National Provider Directory

Locations

145 Sherman Ave
New York, NY 10034
Phone (212) 567-1444

NPI Registry JSON

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

{
    "created_epoch": "1324771200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1414627200000",
    "number": "1265701957",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "145 SHERMAN AVE",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100344604",
            "telephone_number": "212-567-1444",
            "fax_number": "212-567-1448"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "145 SHERMAN AVE",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100344604",
            "telephone_number": "212-567-1444",
            "fax_number": "212-567-1448"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SANTA ISABEL PHARMACY INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-12-25",
        "last_updated": "2014-10-30",
        "status": "A",
        "authorized_official_last_name": "LEON",
        "authorized_official_first_name": "CLARA",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "212-567-1444"
    },
    "taxonomies": [
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "NY",
            "license": "030989",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2133339",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3591242",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "santa isabel pharmacy inc",
            "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 Oct 30, 2014; 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.