Individual provider Active NPI

Shunpei Okochi, M.D.

  • Pediatric Surgery Physician
  • New York, NY
National Provider Identifier
1366880049
Registry record updated Aug 30, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Surgery PhysicianTaxonomy code 2086S0120X
License
280668 Issued in NY
Practice address
1184 5TH Ave
New York, NY 10029-6503
Phone
(212) 241-9500
NPI assigned
Jun 4, 2013
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 30, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Pediatric Surgery Physician 2086S0120X 280668 NY Primary

Addresses

Primary practice location

1184 5TH Ave
New York, NY 10029-6503

Mailing address

1184 5TH Ave
New York, NY 10029-6503
Phone (212) 241-9500

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
I20231017001007 NY Practitioner - General Surgery 7012254501 Reassigns benefits to 2 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
280668NYMDPediatric Surgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Icahn School of Medicine at Mount Sinai Current Accepting new patients
Icahn School of Medicine at Mount Sinai Current Accepting new patients
Icahn School of Medicine at Mount Sinai CurrentSince Oct 1, 2023 Accepting new patients
Icahn School of Medicine at Mount Sinai CurrentSince Oct 1, 2023 Accepting new patients
Icahn School of Medicine at Mount Sinai Pediatric Surgery CurrentSince Oct 18, 2023 Accepting new patients
Icahn School of Medicine at Mount Sinai CurrentSince Oct 18, 2023 Accepting new patients
Icahn School of Medicine at Mount Sinai Past Accepting new patients
Valley Physician Services PC 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

1184 5th Ave
New York, NY 10029
Phone (212) 241-7500

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

Networks

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

Interoperability endpoints

  • Direct secure messaging: shunpei.okochi.1@5622.direct.athenahealth.com

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": "1370304000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1693353600000",
    "number": "1366880049",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1184 5TH AVE",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100296503",
            "telephone_number": "212-241-9500"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1184 5TH AVE",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100296503",
            "telephone_number": "212-241-9500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OKOCHI",
        "first_name": "SHUNPEI",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-06-04",
        "last_updated": "2023-08-30",
        "certification_date": "2023-08-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2086S0120X",
            "taxonomy_group": "",
            "desc": "Surgery, Pediatric Surgery",
            "state": "NY",
            "license": "280668",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

Verify at the official NPI Registry.