Ethan David Loeb, M.D.

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

232033-1 Issued in NY

Practice address

19 Sycamore LN
Roslyn Heights, NY 11577-2521

Phone

(504) 606-7612

NPI assigned

Aug 28, 2007

Last updated

Aug 28, 2007By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

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

Specialty

Internal Medicine

Education

Icahn School of Medicine at Mount Sinai, 1996

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Icahn School of Medicine at Mount SinaiGroup PAC ID 2264691070, 2,809 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Networks

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

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.

• Icahn School of Medicine at Mount Sinai

  dba BISLR Medical Groups of Mount Sinai

  • Internal Medicine Physician
  • New York, NY
  • NPI 1568841930
  Medicare reassignment Care Compare group NPD
• Icahn School of Medicine at Mount Sinai

  dba New York Eye & Ear Optical Shop

  • Eyewear Supplier
  • New York, NY
  • NPI 1760227466
  NPD
• Icahn School of Medicine at Mount Sinai

  dba Medicine Department of Mount Sinai

  • Infectious Disease Physician
  • New York, NY
  • NPI 1659639524

  Internal Medicine

  NPD (past)

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

{
    "created_epoch": "1188259200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1188259200000",
    "number": "1275727711",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "19 SYCAMORE LN",
            "city": "ROSLYN HEIGHTS",
            "state": "NY",
            "postal_code": "115772521",
            "telephone_number": "504-606-7612"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "19 SYCAMORE LN",
            "city": "ROSLYN HEIGHTS",
            "state": "NY",
            "postal_code": "115772521",
            "telephone_number": "504-606-7612"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LOEB",
        "first_name": "ETHAN",
        "middle_name": "DAVID",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-08-28",
        "last_updated": "2007-08-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "CA",
            "license": "A63945",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NY",
            "license": "232033-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Level Medical PLLC
• Li Nutritionist PLLC
• Limarx Pharmacy Inc.
• Stephen Lipsig, M.D.
• Lisa M Cohen LCSW PLLC
• Long Island Minimally Invasive Surgery, P.C.
• Long Island Psychotherapy & Counseling, LCSW P.C.
• Long Island Smile Dentistry
• Michael Longobardi, LMHC, CASAC
• Alexandra Helen Lore, LCSW

• Internal Medicine Physician in Roslyn Heights, NY
• Providers in Roslyn Heights, NY by specialty
• Internal Medicine Physician in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 28, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• 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.