NPIMap

Organization Active NPI

McLean Heights Medical Professionals PC

  • Gastroenterology Physician
  • Yonkers, NY
National Provider Identifier
1326158395
Registry record updated Jan 11, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gastroenterology PhysicianTaxonomy code 207RG0100X
Legal business name
MCLEAN HEIGHTS MEDICAL PROFESSIONALS PC
Practice address
750 McLean Ave
Yonkers, NY 10704-3842
Phone
(914) 803-0310
Fax
(914) 803-0349
NPI assigned
Aug 30, 2006
Last updated
Jan 11, 2010By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 11, 2010

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

Authorized official

Name
Ingrid Colon
Title
Office Manager
Phone
(914) 803-0310

Specialties & licenses 7

Specialty (taxonomy)CodeLicenseStatePrimary
Cardiovascular Disease Physician 207RC0000X 193986 NY
Gastroenterology Physician 207RG0100X NU Primary
Interventional Cardiology Physician 207RI0011X 193986 NY
Nuclear Medicine Physician 207U00000X 193986 NY
Nuclear Cardiology Physician 207UN0901X 193986 NY
Nuclear Imaging & Therapy Physician 207UN0902X 193986 NY
Nuclear Radiology Physician 2085N0904X 193986 NY

Addresses

Primary practice location

750 McLean Ave
Yonkers, NY 10704-3842

Mailing address

750 McLean Ave
Yonkers, NY 10704-3842
Phone (914) 803-0310

Other identifiers 1

IdentifierTypeStateIssuer
02374303MedicaidNY

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040323000213 NY Part B Supplier - Clinic/Group Practice 2264323955 Receives reassigned benefits from 4 practitioners
Practice locations: Corona, NY; New York, NY

National Provider Directory

National Provider Directory

Locations

4915 Broadway
Apt 1A
New York, NY 10034
Phone (212) 567-0008

Practitioners & affiliated clinicians

Practitioners 11

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.

NPI Registry JSON

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

{
    "created_epoch": "1156896000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1263168000000",
    "number": "1326158395",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "750 MCLEAN AVE",
            "city": "YONKERS",
            "state": "NY",
            "postal_code": "107043842",
            "telephone_number": "914-803-0310",
            "fax_number": "914-803-0349"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "750 MCLEAN AVE",
            "city": "YONKERS",
            "state": "NY",
            "postal_code": "107043842",
            "telephone_number": "914-803-0310",
            "fax_number": "914-803-0349"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MCLEAN HEIGHTS MEDICAL PROFESSIONALS PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-30",
        "last_updated": "2010-01-11",
        "status": "A",
        "authorized_official_last_name": "COLON",
        "authorized_official_first_name": "INGRID",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "914-803-0310"
    },
    "taxonomies": [
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "NY",
            "license": "193986",
            "primary": false
        },
        {
            "code": "207RG0100X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "207RI0011X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Interventional Cardiology",
            "state": "NY",
            "license": "193986",
            "primary": false
        },
        {
            "code": "207U00000X",
            "taxonomy_group": "",
            "desc": "Nuclear Medicine",
            "state": "NY",
            "license": "193986",
            "primary": false
        },
        {
            "code": "207UN0901X",
            "taxonomy_group": "",
            "desc": "Nuclear Medicine, Nuclear Cardiology",
            "state": "NY",
            "license": "193986",
            "primary": false
        },
        {
            "code": "207UN0902X",
            "taxonomy_group": "",
            "desc": "Nuclear Medicine, Nuclear Imaging & Therapy",
            "state": "NY",
            "license": "193986",
            "primary": false
        },
        {
            "code": "2085N0904X",
            "taxonomy_group": "",
            "desc": "Radiology, Nuclear Radiology",
            "state": "NY",
            "license": "193986",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02374303",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Yonkers, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 11, 2010; 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.