Individual provider Active NPI

S. Kenneth Schonberg, MD

  • Pediatrics Physician
  • Bronx, NY
National Provider Identifier
1295805406
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
097096 Issued in NY
Practice address
MMC - Dept. of Pediatrics
111 East 210TH Street
Bronx, NY 10467
Phone
(718) 696-4062
NPI assigned
Nov 8, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 097096 NY Primary

Addresses

Primary practice location

MMC - Dept. of Pediatrics
111 East 210TH Street
Bronx, NY 10467

Mailing address

15 Hidden Hollow LN
Millwood, NY 10546-1008
Phone (718) 696-4062

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
I20210827002456 NY Practitioner - Pediatric Medicine 8628473725 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
097096NYMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Montefiore Medical Center CurrentSince May 25, 2021 Accepting new patients
Montefiore Medical Center Pediatrics CurrentSince May 25, 2021 Accepting new patients

Locations

111 E 210th St
Bronx, NY 10467

Networks

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

Organizations & group practices 2

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.

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": "1183852800000",
    "number": "1295805406",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15 HIDDEN HOLLOW LN",
            "city": "MILLWOOD",
            "state": "NY",
            "postal_code": "105461008",
            "telephone_number": "718-696-4062"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "MMC - DEPT. OF PEDIATRICS",
            "address_2": "111 EAST 210TH STREET",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "10467",
            "telephone_number": "718-696-4062"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SCHONBERG",
        "first_name": "S. KENNETH",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-11-08",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "NY",
            "license": "097096",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bronx, NY

Sources for this page

Verify at the official NPI Registry.