Individual provider Active NPI

Christopher John Smolock, M.D.

  • Vascular Surgery Physician
  • Astoria, NY
National Provider Identifier
1336364991
Registry record updated Feb 14, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Vascular Surgery PhysicianTaxonomy code 2086S0129X
License
320110 Issued in NY
Practice address
2510 30TH Ave
Astoria, NY 11102-2448
Phone
(718) 932-1000
NPI assigned
Apr 17, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 14, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Vascular Surgery Physician 2086S0129X N6033 TX
Vascular Surgery Physician 2086S0129X 320110 NY Primary

Addresses

Primary practice location

2510 30TH Ave
Astoria, NY 11102-2448

Mailing address

2510 30TH Ave
Astoria, NY 11102-2448
Phone (718) 932-1000

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
I20230104002504 NY Practitioner - Obstetrics/GynecologyPractitioner - Vascular Surgery 3375790595 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Obstetrics/Gynecology
Education
Jefferson Medical College of Thomas Jefferson University, 2002
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Icahn School of Medicine at Mount SinaiGroup PAC ID 2264691070, 2,809 clinicians

Practice addresses (Care Compare)

2520 30TH Ave
Long Island City, NY 11102-2448
Phone (718) 808-7777

Hospital & facility affiliations

  • Mount Sinai Hospital Hospital, New York, NY, CCN 330024
  • Mount Sinai West Hospital, New York, NY, CCN 330046

Procedures performed for Medicare patients

ProcedureNumber of procedures
Leg revascularization (restoring blood flow)1-10
Removal of tissue20

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
N6033TXMDVascular Surgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Icahn School of Medicine at Mount Sinai CurrentSince Jan 1, 2023 Accepting new patients
Icahn School of Medicine at Mount Sinai CurrentSince Jul 22, 2023 Accepting new patients
Icahn School of Medicine at Mount Sinai Current Accepting new patients
Icahn School of Medicine at Mount Sinai CurrentSince Jan 1, 2023 Accepting new patients
Icahn School of Medicine at Mount Sinai CurrentSince Jul 22, 2023 Accepting new patients
Metropolitan Medical Practice Plan PC CurrentSince Jul 1, 2022 Accepting new patients
Euclid Hospital Cleveland Clinic Health System Current Accepting new patients
Icahn School of Medicine at Mount Sinai Current Accepting new patients
Mount Sinai Hospital Past Accepting new patients
Icahn School of Medicine at Mount Sinai Past Accepting new patients

Locations

7901 Broadway
Rm A119
Elmhurst, NY 11373
Phone (718) 334-3915

13620 38th Ave
Flushing, NY 11354
Phone (718) 353-7701

2520 30th Ave
Long Island City, NY 11102
Phone (718) 267-4230

2510 30th Ave
Long Island City, NY 11102
Phone (718) 267-4245

5 E 98th St
New York, NY 10029
Phone (212) 241-3986

1901 1st Ave
New York, NY 10029
Phone (212) 230-6262

Networks

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

Interoperability endpoints

  • Direct secure messaging: csmolock167717@direct.ccf.org

Organizations & group practices 10

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 8

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": "1176768000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1676332800000",
    "number": "1336364991",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2510 30TH AVE",
            "city": "ASTORIA",
            "state": "NY",
            "postal_code": "111022448",
            "telephone_number": "718-932-1000",
            "fax_number": "718-906-6201"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2510 30TH AVE",
            "city": "ASTORIA",
            "state": "NY",
            "postal_code": "111022448",
            "telephone_number": "718-932-1000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMOLOCK",
        "first_name": "CHRISTOPHER",
        "middle_name": "JOHN",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-04-17",
        "last_updated": "2023-02-14",
        "certification_date": "2023-02-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2086S0129X",
            "taxonomy_group": "",
            "desc": "Surgery, Vascular Surgery",
            "state": "TX",
            "license": "N6033",
            "primary": false
        },
        {
            "code": "2086S0129X",
            "taxonomy_group": "",
            "desc": "Surgery, Vascular Surgery",
            "state": "NY",
            "license": "320110",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Astoria, NY

Sources for this page

Verify at the official NPI Registry.