Individual provider Active NPI

Edwardine Mathura Mirnalini Mohanraj, MD

  • Pulmonary Disease Physician
  • New York, NY
National Provider Identifier
1417079625
Registry record updated Mar 28, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pulmonary Disease PhysicianTaxonomy code 207RP1001X
License
243447 Issued in NY
Practice address
425 W 59TH St
8TH FL
New York, NY 10019-8022
Phone
(212) 492-5500
NPI assigned
Apr 6, 2007
Last updated
Mar 28, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 28, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Critical Care Medicine (Internal Medicine) Physician 207RC0200X 243447 NY
Pulmonary Disease Physician 207RP1001X 243447 NY Primary

Addresses

Primary practice location

425 W 59TH St
8TH FL
New York, NY 10019-8022

Mailing address

150 E 42ND St FL 9
New York, NY 10017-5699
Phone (646) 605-8188

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
I20100908000698 NY Practitioner - Pulmonary DiseasePractitioner - Internal MedicinePractitioner - Critical Care (Intensivists) 8729103114 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Pulmonary DiseaseAlso: Critical Care (Intensivists), Internal Medicine
Education
University of Connecticut School of Medicine, 2003
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Icahn School of Medicine at Mount SinaiGroup PAC ID 2264691070, shared by 32 NPIs, 2,809 clinicians

Practice addresses (Care Compare)

2510 30TH Ave
Long Island City, NY 11102-2448
Phone (718) 932-1000

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Icahn School of Medicine at Mount Sinai CurrentSince Jan 1, 2016 Accepting new 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 Critical Care Medicine CurrentSince Nov 1, 2017 Accepting new patients
Icahn School of Medicine at Mount Sinai CurrentSince Jan 1, 2016 Accepting new patients
Icahn School of Medicine at Mount Sinai CurrentSince Nov 1, 2017 Accepting new patients
Icahn School of Medicine at Mount Sinai CurrentSince Feb 1, 2022 Accepting new patients
St Lukes Roosevelt Hospital Center Past Accepting new patients

Locations

13620 38th Ave
Flushing, NY 11354
Phone (718) 353-7701

2510 30th Ave
Long Island City, NY 11102
Phone (718) 267-4245

200 Old Country Rd
Mineola, NY 11501
Phone (516) 408-4900

10 Union Sq E
New York, NY 10003
Phone (212) 253-6800

1000 10th Ave
New York, NY 10019
Phone (212) 523-2369

1111 Amsterdam Ave
New York, NY 10025
Phone (212) 523-2309

150 E 42nd St
Fl 10
New York, NY 10017
Phone (646) 605-8119

150 E 42nd St
Fl 9
New York, NY 10017
Phone (646) 605-8119

425 W 59th St
Fl 8
New York, NY 10019
Phone (212) 492-5500

Networks

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

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1175817600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1743120000000",
    "number": "1417079625",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "150 E 42ND ST FL 9",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100175699",
            "telephone_number": "646-605-8188"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "425 W 59TH ST",
            "address_2": "8TH FL",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100198022",
            "telephone_number": "212-492-5500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOHANRAJ",
        "first_name": "EDWARDINE",
        "middle_name": "MATHURA MIRNALINI",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-04-06",
        "last_updated": "2025-03-28",
        "certification_date": "2025-03-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RC0200X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Critical Care Medicine",
            "state": "NY",
            "license": "243447",
            "primary": false
        },
        {
            "code": "207RP1001X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Pulmonary Disease",
            "state": "NY",
            "license": "243447",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

Verify at the official NPI Registry.