Individual provider Active NPI

Robert Pass

  • Pediatric Cardiology Physician
  • New York, NY
National Provider Identifier
1366414039
Registry record updated Aug 16, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Cardiology PhysicianTaxonomy code 2080P0202X
License
190719 Issued in NY
Practice address
3959 Broadway
Columbia University Department Pediatrics
New York, NY 10032-1559
Phone
(212) 604-7297
NPI assigned
Feb 6, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 16, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Cardiology Physician 2080P0202X 190719 NY Primary

Addresses

Primary practice location

3959 Broadway
Columbia University Department Pediatrics
New York, NY 10032-1559

Mailing address

205 W End Ave
New York, NY 10023-4806
Phone (212) 304-7250

Other identifiers 1

IdentifierTypeStateIssuer
01798003MedicaidNY

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY, NJ2 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
I20070613000123 NY Practitioner - Pediatric MedicinePractitioner - Cardiovascular Disease (Cardiology) 7911005046 Reassigns benefits to 2 organizations
I20221222000949 NJ Practitioner - Pediatric Medicine 7911005046 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Pediatric MedicineAlso: Cardiovascular Disease (Cardiology)
Education
Boston University School of Medicine, 1991
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Icahn School of Medicine at Mount SinaiGroup PAC ID 2264691070, 2,809 clinicians

Practice addresses (Care Compare)

1 Gustave L Levy PL
New York, NY 10029-6504
Phone (212) 731-6870

National Provider Directory

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

Practice roles (8 of 12)

OrganizationSpecialtyStatusNew patients
Montefiore Medical Center CurrentSince Nov 20, 2017 Accepting new patients
Icahn School of Medicine at Mount Sinai CurrentSince Apr 6, 2024 Accepting new patients
Valley Physician Services PC CurrentSince Sep 29, 2022 Accepting new patients
Icahn School of Medicine at Mount Sinai CurrentSince Apr 6, 2024 Accepting new patients
Montefiore Medical Center CurrentSince Nov 20, 2017 Accepting new patients
Icahn School of Medicine at Mount Sinai Pediatric Cardiology Current Accepting new patients
Trustees of Columbia University Dept of Obstetrics and Gynecology Past Accepting new patients
Trustees of Columbia University in the City of New York Pediatric Cardiology Past Accepting new patients

Locations

223 N Van Dien Ave
Ridgewood, NJ 07450
Phone (201) 447-8417

111 E 210th St
Bronx, NY 10467

5 E 98th St
Fl 8
New York, NY 10029
Phone (212) 241-4410

Networks

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

Organizations & group practices 8

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.

NPI Registry JSON

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

{
    "created_epoch": "1139184000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1187222400000",
    "number": "1366414039",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "205 W END AVE",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100234806",
            "telephone_number": "212-304-7250"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3959 BROADWAY",
            "address_2": "COLUMBIA UNIVERSITY DEPARTMENT PEDIATRICS",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100321559",
            "telephone_number": "212-604-7297"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PASS",
        "first_name": "ROBERT",
        "name_prefix": "Dr.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-02-06",
        "last_updated": "2007-08-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2080P0202X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Cardiology",
            "state": "NY",
            "license": "190719",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01798003",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

Verify at the official NPI Registry.