NPIMap

Organization Active NPI

Mount Vernon Neighborhood Health Center Inc

Doing business as Mount Vernon Physician Group

  • Specialist
  • Mount Vernon, NY
National Provider Identifier
1295912541
Registry record updated Sep 1, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
5903200R Issued in NY
Legal business name
MOUNT VERNON NEIGHBORHOOD HEALTH CENTER INC
Doing business as
Mount Vernon Physician Group
Practice address
107 W 4TH St
Administration
Mount Vernon, NY 10550-4002
Phone
(914) 699-7200
Fax
(914) 699-0837
NPI assigned
Jan 29, 2008
Last updated
Sep 1, 2021By the provider in NPPES
Organization subpart
Yes
Parent organization
MOUNT VERNON NEIGHORHOOD HEALTH CENTER INCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Sep 1, 2021

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

Authorized official

Name
Ms. Maxine Lewis
Title
Deputy Director Patient Accounts
Phone
(914) 989-7600

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
SpecialistGroup: 193200000X MULTI-SPECIALTY GROUP 174400000X 5903200R NY Primary

Addresses

Primary practice location

107 W 4TH St
Administration
Mount Vernon, NY 10550-4002

Mailing address

107 W 4TH St
Administration
Mount Vernon, NY 10550-4002
Phone (914) 699-7200

Other identifiers 1

IdentifierTypeStateIssuer
02995522MedicaidNY

Other names 1

  • Mount Vernon Physician Group Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040313000345 NY Part B Supplier - Clinic/Group Practice 0345139671 Receives reassigned benefits from 113 practitioners
Practice locations: Mount Vernon, NY

Other NPIs with the same Medicare PAC ID 3

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

National Provider Directory

National Provider Directory
Part of
Mount Vernon Neighborhood Health Center Inc

Interoperability endpoints

  • FHIR API: https://fhir-api.fhirprod.aws.greenwayhealth.com/fhir/R4/2.16.840.1.113883.3.140.71482

Practitioners & affiliated clinicians

Practitioners 114

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 114

NPI Registry JSON

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

{
    "created_epoch": "1201564800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1630454400000",
    "number": "1295912541",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "107 W 4TH ST",
            "address_2": "ADMINISTRATION",
            "city": "MOUNT VERNON",
            "state": "NY",
            "postal_code": "105504002",
            "telephone_number": "914-699-7200",
            "fax_number": "914-699-0837"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "107 W 4TH ST",
            "address_2": "ADMINISTRATION",
            "city": "MOUNT VERNON",
            "state": "NY",
            "postal_code": "105504002",
            "telephone_number": "914-699-7200",
            "fax_number": "914-699-0837"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MOUNT VERNON NEIGHBORHOOD HEALTH CENTER INC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "MOUNT VERNON NEIGHORHOOD HEALTH CENTER INC",
        "enumeration_date": "2008-01-29",
        "last_updated": "2021-09-01",
        "certification_date": "2021-08-31",
        "status": "A",
        "authorized_official_last_name": "LEWIS",
        "authorized_official_first_name": "MAXINE",
        "authorized_official_title_or_position": "DEPUTY DIRECTOR PATIENT ACCOUNTS",
        "authorized_official_telephone_number": "914-989-7600",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Specialist",
            "state": "NY",
            "license": "5903200R",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02995522",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Mount Vernon Physician Group",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Mount Vernon Physician Group",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Mount Vernon, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 1, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.