NPIMap

Organization Active NPI

Metropolitan Medical Practice Plan PC

  • General Practice Physician
  • New York, NY
National Provider Identifier
1306138383
Registry record updated May 9, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice PhysicianTaxonomy code 208D00000X
Legal business name
METROPOLITAN MEDICAL PRACTICE PLAN PC
Practice address
1901 1St Ave
New York, NY 10029-7404
Phone
(212) 423-7337
Fax
(212) 423-6318
NPI assigned
May 9, 2011
Last updated
May 9, 2011By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 9, 2011

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

Authorized official

Name
Sudha Pentyala
Title
Director
Phone
(631) 675-9300

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Physician 208D00000X Primary

Addresses

Primary practice location

1901 1St Ave
New York, NY 10029-7404

Mailing address

234 E 149TH St
Suite 8D-200
Bronx, NY 10451-5504
Phone (718) 579-6017

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20110713000171 NY Part B Supplier - Clinic/Group Practice 8022286384 Receives reassigned benefits from 693 practitioners
Practice locations: New York, NY

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 701

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 701

NPI Registry JSON

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

{
    "created_epoch": "1304899200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1304899200000",
    "number": "1306138383",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "234 E 149TH ST",
            "address_2": "SUITE 8D-200",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "104515504",
            "telephone_number": "718-579-6017",
            "fax_number": "718-579-6060"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1901 1ST AVE",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100297404",
            "telephone_number": "212-423-7337",
            "fax_number": "212-423-6318"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "METROPOLITAN MEDICAL PRACTICE PLAN PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-05-09",
        "last_updated": "2011-05-09",
        "status": "A",
        "authorized_official_last_name": "PENTYALA",
        "authorized_official_first_name": "SUDHA",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "631-675-9300"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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 May 9, 2011; 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.