Individual provider Active NPI

Ivan Colon, M.D.

  • Urology Physician
  • Brooklyn, NY
National Provider Identifier
1366446825
Registry record updated Aug 20, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Urology PhysicianTaxonomy code 208800000X
License
207895 Issued in NY
Practice address
175 Remsen St Ste 1225
Brooklyn, NY 11201-4320
Phone
(631) 751-3000
Fax
(631) 509-6559
NPI assigned
Jun 11, 2005
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 20, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Urology Physician 208800000X 207895 NY Primary

Addresses

Primary practice location

175 Remsen St Ste 1225
Brooklyn, NY 11201-4320

Mailing address

175 Remsen St
FL 12
Brooklyn, NY 11201-4333
Phone (718) 696-0186

Other identifiers 1

IdentifierTypeStateIssuer
00280160MedicaidNY

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
I20080520000039 NY Practitioner - Urology 1759450596 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Urology
Education
University of Wisconsin School of Medicine, 1994
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
North Shore Hematology Oncology Associates PCGroup PAC ID 1456243641, 474 clinicians

Practice addresses (Care Compare)

290 Central Ave
Suite 107
Lawrence, NY 11559-8507
Phone (631) 751-3000

Hospital & facility affiliations

  • Lenox Hill Hospital Hospital, New York, NY, CCN 330119
  • Brooklyn Hospital Center - Downtown Campus Hospital, Brooklyn, NY, CCN 330056

Merit-based Incentive Payment System (MIPS)

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

Procedures performed for Medicare patients

ProcedureNumber of procedures
Prostate resection1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
207895NYMDUrology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
North Shore Hematology Oncology Associates PC CurrentSince Feb 10, 2019 Accepting new patients
Kings Physician Services, PC CurrentSince Nov 11, 2017 Accepting new patients
Kings Physician Services, PC CurrentSince Nov 11, 2017 Accepting new patients
North Shore Hematology Oncology Associates PC Past Accepting new patients

Locations

506 6th St
Brooklyn, NY 11215
Phone (718) 780-3279

175 Remsen St
Fl 12
Brooklyn, NY 11201

322 Linden Blvd
Brooklyn, NY 11226
Phone (718) 230-7788

506 6th St
Ste B
Brooklyn, NY 11215
Phone (718) 780-3677

175 Remsen St
Ste 1225
Brooklyn, NY 11201
Phone (718) 222-2600

9438 58th Ave
Unit G3
Elmhurst, NY 11373
Phone (718) 393-3900

290 Central Ave
Ste 107
Lawrence, NY 11559
Phone (516) 239-8877

500 W 181st St
New York, NY 10033
Phone (212) 396-1174

1500 Route 112
Bldg 4
Port Jefferson Station, NY 11776
Phone (631) 574-8354

48 Route 25A
Smithtown, NY 11787
Phone (631) 862-3540

Networks

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

Interoperability endpoints

  • Direct secure messaging: icolon69145@northwell.direct-ci.com

Organizations & group practices 4

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 2

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": "1118448000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1566259200000",
    "number": "1366446825",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "175 REMSEN ST",
            "address_2": "FL 12",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112014333",
            "telephone_number": "718-696-0186",
            "fax_number": "718-696-0185"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "175 REMSEN ST STE 1225",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112014320",
            "telephone_number": "631-751-3000",
            "fax_number": "631-509-6559"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COLON",
        "first_name": "IVAN",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-06-11",
        "last_updated": "2019-08-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208800000X",
            "taxonomy_group": "",
            "desc": "Urology",
            "state": "NY",
            "license": "207895",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00280160",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Brooklyn, NY

Sources for this page

Verify at the official NPI Registry.