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Icahn School of Medicine at Mount Sinai

Organization Active NPI Pediatrics Physician · New York, NY

NPI 1275802811 · NPPES record last updated Jul 8, 2015

Key facts

NPI
1275802811
Entity type
Organization (NPI type 2)
Primary specialty
Pediatrics Physician 208000000X
Legal business name
ICAHN SCHOOL OF MEDICINE AT MOUNT SINAI
Practice address
500 7TH Ave FL 8
New York, NY 10018-4502
Phone
(212) 731-7895
Fax
(212) 731-6788
NPI assigned
Dec 28, 2011
Organization subpart
No

Authorized official

Name
Crystal Macneill
Title
VP, Cbo Director
Phone
(646) 605-8112

Other NPIs on the same Medicare enrollment 3

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

Practitioners 398

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

View all 398

Medicare participation

Medicare fee-for-service enrollment
Enrolled in NY

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
O20120315000035 NY Part B Supplier - Clinic/Group Practice 2264691070 Receives reassigned benefits from 364 practitioners
3 other NPIs on this enrollment
Practice locations: New York, NY; Scarsdale, NY; Sleepy Hollow, NY; Staten Island, NY; White Plains, NY; Brooklyn, NY; Hartsdale, NY; Huntington, NY…

National Provider Directory

Locations

77 Jericho Tpke
Ste 175
Mineola, NY 11501
Phone (516) 216-5910

1184 5th Ave
Fl 3
New York, NY 10029

10 Union Sq E
#2H
New York, NY 10003
Phone (212) 844-8300

10 Union Sq E
#5M
New York, NY 10003
Phone (212) 253-6800

10 E 102nd St
New York, NY 10029
Phone (212) 241-5656

1468 Madison Ave
Fl 404
New York, NY 10029

1190 5th Ave
#1
New York, NY 10029
Phone (212) 241-4971

425 W 59th St
Ste 7B
New York, NY 10019
Phone (212) 523-8041

10 Union Sq E
Ste 2H2J
New York, NY 10003

5 E 98th St
Fl 56
New York, NY 10029

1468 Madison Ave
Fl 3
New York, NY 10029
Phone (212) 241-3355

2637 Broadway
New York, NY 10025
Phone (917) 575-0133

1468 Madison Ave
Fl 4
New York, NY 10029
Phone (212) 241-4901

1184 5th Ave
Fl 7
New York, NY 10029
Phone (212) 241-8545

1190 5th Ave
Fl 1GP1
New York, NY 10029

10 Union Sq E
Ste 5P
New York, NY 10003
Phone (212) 844-8618

1468 Madison Ave
Fl 344
New York, NY 10029

1468 Madison Ave
#14
New York, NY 10029
Phone (212) 241-1830

1190 5th Ave
Ste GP1
New York, NY 10029

320 E 94th St
New York, NY 10128
Phone (212) 423-2900

234 E 85th St
#4
New York, NY 10028

10 Union Sq E
Ste 2H
New York, NY 10003
Phone (212) 844-8300

310 E 14th St
#9
New York, NY 10003

2052 Richmond Rd
Ste 1C
Staten Island, NY 10306
Phone (718) 273-2626

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician
Group: 193200000X MULTI-SPECIALTY GROUP		 208000000X Yes
Neonatal-Perinatal Medicine Physician
Group: 193200000X MULTI-SPECIALTY GROUP		 2080N0001X
Developmental - Behavioral Pediatrics Physician
Group: 193200000X MULTI-SPECIALTY GROUP		 2080P0006X
Pediatric Allergy/Immunology Physician
Group: 193200000X MULTI-SPECIALTY GROUP		 2080P0201X
Pediatric Cardiology Physician
Group: 193200000X MULTI-SPECIALTY GROUP		 2080P0202X
Pediatric Critical Care Medicine Physician
Group: 193200000X MULTI-SPECIALTY GROUP		 2080P0203X
Pediatric Endocrinology Physician
Group: 193200000X MULTI-SPECIALTY GROUP		 2080P0205X
Pediatric Gastroenterology Physician
Group: 193200000X MULTI-SPECIALTY GROUP		 2080P0206X
Pediatric Hematology & Oncology Physician
Group: 193200000X MULTI-SPECIALTY GROUP		 2080P0207X
Pediatric Infectious Diseases Physician
Group: 193200000X MULTI-SPECIALTY GROUP		 2080P0208X
Pediatric Nephrology Physician
Group: 193200000X MULTI-SPECIALTY GROUP		 2080P0210X
Pediatric Pulmonology Physician
Group: 193200000X MULTI-SPECIALTY GROUP		 2080P0214X
Neurology with Special Qualifications in Child Neurology Physician
Group: 193200000X MULTI-SPECIALTY GROUP		 2084N0402X

Addresses

Primary practice location

500 7TH Ave FL 8
New York, NY 10018-4502

Mailing address

150 East 42ND. Street
10TH FL.
New York, NY 10017-5626
Phone (646) 605-8119

Other names

  • Pediatric Department of Mount Sinai Doing business as

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on Jul 8, 2015.

{
    "created_epoch": "1325030400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1436313600000",
    "number": "1275802811",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "150 EAST 42ND. STREET",
            "address_2": "10TH FL.",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100175626",
            "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": "500 7TH AVE FL 8",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100184502",
            "telephone_number": "212-731-7895",
            "fax_number": "212-731-6788"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ICAHN SCHOOL OF MEDICINE AT MOUNT SINAI",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-12-28",
        "last_updated": "2015-07-08",
        "status": "A",
        "authorized_official_last_name": "MACNEILL",
        "authorized_official_first_name": "CRYSTAL",
        "authorized_official_title_or_position": "VP, CBO DIRECTOR",
        "authorized_official_telephone_number": "646-605-8112"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Pediatrics",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "2080N0001X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Pediatrics, Neonatal-Perinatal Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2080P0006X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Pediatrics, Developmental - Behavioral Pediatrics",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2080P0201X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Pediatrics, Pediatric Allergy/Immunology",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2080P0202X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Pediatrics, Pediatric Cardiology",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2080P0203X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Pediatrics, Pediatric Critical Care Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2080P0205X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Pediatrics, Pediatric Endocrinology",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2080P0206X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Pediatrics, Pediatric Gastroenterology",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2080P0207X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Pediatrics, Pediatric Hematology-Oncology",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2080P0208X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Pediatrics, Pediatric Infectious Diseases",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2080P0210X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Pediatrics, Pediatric Nephrology",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2080P0214X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Pediatrics, Pediatric Pulmonology",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2084N0402X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychiatry & Neurology, Neurology with Special Qualifications in Child Neurology",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Pediatric Department of Mount Sinai",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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Sources for this page

Verify at the official NPI Registry.