Individual provider Active NPI

William Martimucci, MD

  • Geriatric Medicine (Internal Medicine) Physician
  • Rye, NY
National Provider Identifier
1336128198
Registry record updated Oct 16, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Geriatric Medicine (Internal Medicine) PhysicianTaxonomy code 207RG0300X
License
177089 Issued in NY
Practice address
1 Theall Rd
Rye, NY 10580-1404
Phone
(914) 848-8700
Fax
(914) 682-6403
NPI assigned
Jan 11, 2006
Last updated
Oct 16, 2013By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 16, 2013

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Geriatric Medicine (Internal Medicine) Physician 207RG0300X 177089 NY Primary
Geriatric Medicine (Internal Medicine) Physician 207RG0300X 036100 CT

Addresses

Primary practice location

1 Theall Rd
Rye, NY 10580-1404

Mailing address

210 Westchester Ave
3Rd Floor
White Plains, NY 10604-2901
Phone (914) 681-3146

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CT, NY2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20060309000623 CT Practitioner - Internal Medicine 9638186067 Reassigns benefits to 1 organization
I20070806000522 NY Practitioner - Internal Medicine 9638186067

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
036100CTMDGeriatric Medicine (Internal Medicine) Physician
177089NYMDGeriatric Medicine (Internal Medicine) Physician

Interoperability endpoints

  • Direct secure messaging: wmartimucci@hiemail.healtheconnections.org

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1136937600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1381881600000",
    "number": "1336128198",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "210 WESTCHESTER AVE",
            "address_2": "3RD FLOOR",
            "city": "WHITE PLAINS",
            "state": "NY",
            "postal_code": "106042901",
            "telephone_number": "914-681-3146",
            "fax_number": "914-682-6403"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 THEALL RD",
            "city": "RYE",
            "state": "NY",
            "postal_code": "105801404",
            "telephone_number": "914-848-8700",
            "fax_number": "914-682-6403"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARTIMUCCI",
        "first_name": "WILLIAM",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-01-11",
        "last_updated": "2013-10-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RG0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Geriatric Medicine",
            "state": "NY",
            "license": "177089",
            "primary": true
        },
        {
            "code": "207RG0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Geriatric Medicine",
            "state": "CT",
            "license": "036100",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Rye, NY

Sources for this page

Verify at the official NPI Registry.