Individual provider Active NPI

Ilana Alexis Stein, D.O.

  • Pediatrics Physician
  • Bronx, NY
National Provider Identifier
1407387350
Registry record updated Jul 30, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
302936 Issued in NY
Practice address
4487 3Rd Ave
Bronx, NY 10457-1526
Phone
(718) 960-9331
NPI assigned
Mar 22, 2017
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 30, 2020

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 302936 NY Primary

Addresses

Primary practice location

4487 3Rd Ave
Bronx, NY 10457-1526

Mailing address

4422 Third Ave
Dept Pediatrics, Mills 4TH Floor
Bronx, NY 10457-2012

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
I20200928000716 NY Practitioner - Pediatric Medicine 9234558180 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
302936NYMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
SBH Physicians, PC Pediatrics CurrentSince Mar 1, 2020 Accepting new patients
SBH Physicians, PC Pediatrics Current Accepting new patients
Quarry Road Emergency Services P.C. Past Accepting new patients
St. Barnabas Hospital PastSince Aug 2, 2020 Accepting new patients

Locations

4507 3rd Ave
Bronx, NY 10457
Phone (718) 960-3730

4422 3rd Ave
Fl 4
Bronx, NY 10457
Phone (718) 960-3100

4422 3rd Ave
Bronx, NY 10457
Phone (718) 960-3917

4487 3rd Ave
Bronx, NY 10457
Phone (718) 960-3730

Networks

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

Interoperability endpoints

  • Direct secure messaging: istein19181@sbhny.direct-ci.net

Organizations & group practices 4

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": "1490140800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1596067200000",
    "number": "1407387350",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4422 THIRD AVE",
            "address_2": "DEPT PEDIATRICS, MILLS 4TH FLOOR",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "104572012"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4487 3RD AVE",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "104571526",
            "telephone_number": "718-960-9331"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STEIN",
        "first_name": "ILANA",
        "middle_name": "ALEXIS",
        "credential": "D.O.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-03-22",
        "last_updated": "2020-07-30",
        "certification_date": "2020-07-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "NY",
            "license": "302936",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bronx, NY

Sources for this page

Verify at the official NPI Registry.