Individual provider Active NPI

David Jeffrey Carruthers, M.D.

  • Endocrinology, Diabetes & Metabolism Physician
  • Bronx, NY
National Provider Identifier
1316333628
Registry record updated Jul 23, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Endocrinology, Diabetes & Metabolism PhysicianTaxonomy code 207RE0101X
License
300134 Issued in NY
Practice address
1180 Morris Park Ave
Bronx, NY 10461-1925
Phone
(866) 633-8255
Fax
(718) 239-6912
NPI assigned
Apr 13, 2015
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 23, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Endocrinology, Diabetes & Metabolism Physician 207RE0101X 300134 NY Primary

Addresses

Primary practice location

1180 Morris Park Ave
Bronx, NY 10461-1925

Mailing address

1180 Morris Park Ave
Bronx, NY 10461-1925
Phone (866) 633-8255

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
I20200826000244 NY Practitioner - Endocrinology 5890033468 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Endocrinology
Education
New York University School of Medicine, 2015
Medicare assignment
May accept Medicare assignment
Telehealth
Offers telehealth services
Group practices
Montefiore Medical CenterGroup PAC ID 3779496021, 2,809 clinicians

Practice addresses (Care Compare)

111 E 210TH St
Bronx, NY 10467-2401
Phone (718) 920-4321

1111 Westchester Ave
West Harrison, NY 10604-3525
Phone (914) 327-2700

161 Fort Washington Ave
New York, NY 10032-3729
Phone (212) 305-8559

622 W 168TH St
New York, NY 10032-3720

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
100 of 100Reported as group
Promoting interoperability
100
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
300134NYMDEndocrinology, Diabetes & Metabolism Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Montefiore Medical Center Endocrinology, Diabetes & Metabolism CurrentSince Apr 25, 2020 Accepting new patients
Trustees of Columbia University in the City of New York CurrentSince Sep 2, 2025 Accepting new patients
Montefiore Medical Center CurrentSince Apr 25, 2020 Accepting new patients
Trustees of Columbia University in the City of New York CurrentSince Sep 2, 2025 Accepting new patients
Physician Affiliate Group of New York PC CurrentSince Mar 1, 2024 Accepting new patients
Trustees of Columbia University in the Department of Otolaryngology Past Accepting new patients

Locations

1180 Morris Park Ave
Bronx, NY 10461
Phone (718) 829-1500

111 E 210th St
Bronx, NY 10467

2601 Ocean Pkwy
Brooklyn, NY 11235
Phone (718) 616-5354

555 Taxter Rd
Fl 3
Elmsford, NY 10523
Phone (914) 457-4130

630 W 168th St
#4
New York, NY 10032
Phone (212) 305-6387

622 W 168th St
New York, NY 10032
Phone (212) 305-4931

550 1st Ave
New York, NY 10016
Phone (212) 263-3293

161 Fort Washington Ave
New York, NY 10032
Phone (212) 305-8559

506 Malcolm X Blvd
New York, NY 10037
Phone (212) 939-1000

1111 Westchester Ave
White Plains, NY 10604
Phone (212) 305-1021

Networks

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

Interoperability endpoints

  • FHIR API: https://epicproxy-pub.et1089.epichosted.com/FHIRProxy/api/FHIR/R4/
  • FHIR API: https://epicproxy-pub.et1089.epichosted.com/FHIRProxy/api/FHIR/DSTU2/

Organizations & group practices 6

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.

Hospital & facility affiliations 7

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1428883200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1595462400000",
    "number": "1316333628",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1180 MORRIS PARK AVE",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "104611925",
            "telephone_number": "866-633-8255",
            "fax_number": "718-239-6912"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1180 MORRIS PARK AVE",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "104611925",
            "telephone_number": "866-633-8255",
            "fax_number": "718-239-6912"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CARRUTHERS",
        "first_name": "DAVID",
        "middle_name": "JEFFREY",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-04-13",
        "last_updated": "2020-07-23",
        "certification_date": "2020-07-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RE0101X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Endocrinology, Diabetes & Metabolism",
            "state": "NY",
            "license": "300134",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bronx, NY

Sources for this page

Verify at the official NPI Registry.