Individual provider Active NPI

Michael L Traub, MD

  • Obstetrics & Gynecology Physician
  • Staten Island, NY
National Provider Identifier
1366513749
Registry record updated Mar 9, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X
License
239154 Issued in NY
Practice address
237 Richmond Valley Rd
Staten Island, NY 10309-2622
Phone
(718) 948-6100
Fax
(718) 948-6114
NPI assigned
Nov 10, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 9, 2016

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics & Gynecology Physician 207V00000X 239154 NY Primary
Obstetrics & Gynecology Physician 207V00000X 25MA08559900 NJ

Addresses

Primary practice location

237 Richmond Valley Rd
Staten Island, NY 10309-2622

Mailing address

237 Richmond Valley Rd
Staten Island, NY 10309-2622
Phone (718) 948-6100

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
I20080104000205 NY Practitioner - Obstetrics/GynecologyPractitioner - Other (Physician) 1052491933 Reassigns benefits to 1 organization
I20130205000221 NJ Practitioner - Obstetrics/Gynecology 1052491933 Reassigns benefits to 1 organization

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Island Reproductive Services, PC CurrentSince Nov 2, 2012 Accepting new patients

Locations

3000 Hadley Rd
Fl 2
South Plainfield, NJ 07080
Phone (718) 948-6100

237 Richmond Valley Rd
Staten Island, NY 10309
Phone (718) 948-6100

1110 South Ave
Ste 305
Staten Island, NY 10314
Phone (718) 226-4645

Networks

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

Interoperability endpoints

  • Direct secure messaging: mtraub67489@northwell.direct-ci.com

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1163116800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1457481600000",
    "number": "1366513749",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "237 RICHMOND VALLEY RD",
            "city": "STATEN ISLAND",
            "state": "NY",
            "postal_code": "103092622",
            "telephone_number": "718-948-6100",
            "fax_number": "718-948-6114"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "237 RICHMOND VALLEY RD",
            "city": "STATEN ISLAND",
            "state": "NY",
            "postal_code": "103092622",
            "telephone_number": "718-948-6100",
            "fax_number": "718-948-6114"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TRAUB",
        "first_name": "MICHAEL",
        "middle_name": "L",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-11-10",
        "last_updated": "2016-03-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "NY",
            "license": "239154",
            "primary": true
        },
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "NJ",
            "license": "25MA08559900",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Staten Island, NY

Sources for this page

Verify at the official NPI Registry.