Individual provider Active NPI

Altagracia B Tolentino, MD

  • Pediatrics Physician
  • Bronx, NY
National Provider Identifier
1396815593
Registry record updated Jan 26, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
201735 Issued in NY
Practice address
890 Prospect Avenue
Center for Children Health and Resiliency
Bronx, NY 10459
Phone
(718) 991-0605
NPI assigned
Nov 8, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 26, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 201735 NY Primary

Addresses

Primary practice location

890 Prospect Avenue
Center for Children Health and Resiliency
Bronx, NY 10459

Mailing address

2411 Gunther Ave
Bronx, NY 10469-6245
Phone (718) 991-0605

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
I20050309000101 NY Practitioner - Pediatric Medicine 1557315934 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
201735NYMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Montefiore Medical Center CurrentSince May 3, 2010 Accepting new patients
Montefiore Medical Center Pediatrics CurrentSince May 3, 2010 Accepting new patients

Locations

871 Prospect Ave
Bronx, NY 10459
Phone (718) 991-0605

111 E 210th St
Bronx, NY 10467

Networks

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

Organizations & group practices 2

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": "1162944000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1327536000000",
    "number": "1396815593",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2411 GUNTHER AVE",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "104696245",
            "telephone_number": "718-991-0605",
            "fax_number": "718-991-2931"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "890 PROSPECT AVENUE",
            "address_2": "CENTER FOR CHILDREN HEALTH AND RESILIENCY",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "10459",
            "telephone_number": "718-991-0605"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TOLENTINO",
        "first_name": "ALTAGRACIA",
        "middle_name": "B",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-11-08",
        "last_updated": "2012-01-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "NY",
            "license": "201735",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bronx, NY

Sources for this page

Verify at the official NPI Registry.