Individual provider Active NPI

Carol Eleanor Tondu-Small, MD

  • Pediatric Adolescent Medicine Physician
  • Brooklyn, NY
National Provider Identifier
1376620542
Registry record updated Mar 25, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Adolescent Medicine PhysicianTaxonomy code 2080A0000X
License
180122 Issued in NY
Practice address
760 Broadway, Woodhull Medical & Mental Health Center
Department of Pediatrics
Brooklyn, NY 11206
Phone
(718) 963-8000
Fax
(718) 630-3122
NPI assigned
Nov 1, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 25, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Adolescent Medicine Physician 2080A0000X 180122 NY Primary

Addresses

Primary practice location

760 Broadway, Woodhull Medical & Mental Health Center
Department of Pediatrics
Brooklyn, NY 11206

Mailing address

760 Broadway, Woodhull Medical & Mental Health Center
Department of Pediatrics Room 2B-321
Brooklyn, NY 11206
Phone (718) 963-8000

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
180122NYMDPediatric Adolescent Medicine Physician

Interoperability endpoints

  • Direct secure messaging: ctondusmall563069@nychhc.direct-ci.com

NPI Registry JSON

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

{
    "created_epoch": "1162339200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1395705600000",
    "number": "1376620542",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "760 BROADWAY, WOODHULL MEDICAL & MENTAL HEALTH CENTER",
            "address_2": "DEPARTMENT OF PEDIATRICS ROOM 2B-321",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "11206",
            "telephone_number": "718-963-8000",
            "fax_number": "718-630-3122"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "760 BROADWAY, WOODHULL MEDICAL & MENTAL HEALTH CENTER",
            "address_2": "DEPARTMENT OF PEDIATRICS",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "11206",
            "telephone_number": "718-963-8000",
            "fax_number": "718-630-3122"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TONDU-SMALL",
        "first_name": "CAROL",
        "middle_name": "ELEANOR",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-11-01",
        "last_updated": "2014-03-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2080A0000X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Adolescent Medicine",
            "state": "NY",
            "license": "180122",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brooklyn, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 25, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.