Organization Active NPI

Corinthian Medical PC

  • Internal Medicine Physician
  • New York, NY
National Provider Identifier
1396332953
Registry record updated Sep 20, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
Legal business name
CORINTHIAN MEDICAL PC
Practice address
620 W 190TH St # B
New York, NY 10040-4157
Phone
(212) 781-4144
Fax
(212) 781-1872
NPI assigned
Dec 29, 2020
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 20, 2023

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

Authorized official

Name
Carolina De Los Angeles
Title
Administrator
Phone
(347) 812-3968

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207R00000X Primary

Addresses

Primary practice location

620 W 190TH St # B
New York, NY 10040-4157

Mailing address

620 W 190TH St # B
New York, NY 10040-4157
Phone (212) 781-4144

Electronic endpoints 1

TypeEndpointUseAffiliation
Other URL ECW Health Information Exchange (HIE)

National Provider Directory

National Provider Directory

Locations

330 Wadsworth Ave
Apt 1A
New York, NY 10040
Phone (212) 781-4144

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1609200000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1695168000000",
    "number": "1396332953",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "620 W 190TH ST # B",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100404157",
            "telephone_number": "212-781-4144",
            "fax_number": "212-781-1872"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "620 W 190TH ST # B",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100404157",
            "telephone_number": "212-781-4144",
            "fax_number": "212-781-1872"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CORINTHIAN MEDICAL PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-12-29",
        "last_updated": "2023-09-20",
        "certification_date": "2023-09-20",
        "status": "A",
        "authorized_official_last_name": "DE LOS ANGELES",
        "authorized_official_first_name": "CAROLINA",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "347-812-3968"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "ECW",
            "affiliation": "N",
            "endpointDescription": "EMR",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "EMR",
            "address_1": "620 W 190th St # B",
            "city": "New York",
            "state": "NY",
            "country_code": "US",
            "postal_code": "100404157",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 20, 2023; 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.