NPIMap

Organization Active NPI

Icahn School of Medicine at Mount Sinai

Doing business as Mount Sinai Doctors South Nassau

  • Cardiovascular Disease Physician
  • Oceanside, NY
National Provider Identifier
1417449976
Registry record updated May 31, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Cardiovascular Disease PhysicianTaxonomy code 207RC0000X
Legal business name
ICAHN SCHOOL OF MEDICINE AT MOUNT SINAI
Doing business as
Mount Sinai Doctors South Nassau
Practice address
1 Healthy Way
Oceanside, NY 11572
Phone
(516) 255-1618
NPI assigned
May 31, 2018
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 31, 2018

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

Authorized official

Name
Alicia Gresham
Title
VP of Network Operations
Phone
(212) 659-9038

Specialties & licenses 15

Specialty (taxonomy)CodeLicenseStatePrimary
Cognitive & Behavioral PsychologistGroup: 193200000X MULTI-SPECIALTY GROUP 103TB0200X
Family Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207Q00000X
Internal Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207R00000X
Cardiovascular Disease PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207RC0000X Primary
Hematology & Oncology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207RH0003X
Obstetrics & Gynecology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207V00000X
Maternal & Fetal Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207VM0101X
Clinical Pathology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207ZC0006X
Neonatal-Perinatal Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 2080N0001X
Physical Medicine & Rehabilitation PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 208100000X
Behavioral Neurology & Neuropsychiatry PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 2084B0040X
Radiation Oncology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 2085R0001X
Diagnostic Radiology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 2085R0202X
Surgery PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 208600000X
Hospitalist PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 208M00000X

Addresses

Primary practice location

1 Healthy Way
Oceanside, NY 11572

Mailing address

1 Healthy Way
Oceanside, NY 11572-1551
Phone (516) 255-1618

Other practice location 1

250 Fulton Ave Fl 1
Hempstead, NY 11550-3917
Phone (516) 255-8400

Other practice location 2

2280 Grand Ave Ste 208
Baldwin, NY 11510-3110
Phone (516) 623-4800

Other practice location 3

2277 Grand Ave
Baldwin, NY 11510-3148
Phone (516) 623-4800

Other practice location 4

2209 Merrick Rd Ste 101
Merrick, NY 11566-4770
Phone (516) 546-5000

Other practice location 5

215 Rockaway Tpke
Lawrence, NY 11559-1216
Phone (516) 374-5024

Other practice location 6

196 Merrick Rd
Oceanside, NY 11572-1420
Phone (516) 255-8400

Other practice location 7

185 Merrick Rd
Oceanside, NY 11572-1431
Phone (516) 766-6550

Other practice location 8

175 Fulton Ave Ste 309
Hempstead, NY 11550-3702
Phone (516) 546-1370

Other practice location 9

155 W Merrick Rd
Freeport, NY 11520-3743
Phone (516) 379-3139

Other practice location 10

1436 Broadway
Hewlett, NY 11557-1405
Phone (516) 497-7422

Other practice location 11

1420 Broadway
Hewlett, NY 11557-1321
Phone (516) 374-8631

Other practice location 12

123 Grove Ave Ste 216
Cedarhurst, NY 11516-2302
Phone (516) 569-5200

Other practice location 13

1200 W Broadway Unit 5
Hewlett, NY 11557-1913
Phone (516) 887-7000

Other practice location 14

10 E Merrick Rd Ste 207
Valley Stream, NY 11580-5800
Phone (516) 256-2017

Other names 1

  • MOUNT SINAI DOCTORS SOUTH NASSAU Doing business as

National Provider Directory

National Provider Directory

Locations

2277 Grand Ave
Baldwin, NY 11510
Phone (516) 377-5400

1436 Broadway
Hewlett, NY 11557
Phone (516) 563-7200

NPI Registry JSON

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

{
    "created_epoch": "1527724800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1527724800000",
    "number": "1417449976",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 HEALTHY WAY",
            "city": "OCEANSIDE",
            "state": "NY",
            "postal_code": "115721551",
            "telephone_number": "516-255-1618"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 HEALTHY WAY",
            "city": "OCEANSIDE",
            "state": "NY",
            "postal_code": "11572",
            "telephone_number": "516-255-1618"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "250 Fulton Ave Fl 1",
            "address_purpose": "LOCATION",
            "city": "Hempstead",
            "state": "NY",
            "postal_code": "115503917",
            "country_code": "US",
            "telephone_number": "516-255-8400",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2280 Grand Ave Ste 208",
            "address_purpose": "LOCATION",
            "city": "Baldwin",
            "state": "NY",
            "postal_code": "115103110",
            "country_code": "US",
            "telephone_number": "516-623-4800",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2277 Grand Ave",
            "address_purpose": "LOCATION",
            "city": "Baldwin",
            "state": "NY",
            "postal_code": "115103148",
            "country_code": "US",
            "telephone_number": "516-623-4800",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2209 Merrick Rd Ste 101",
            "address_purpose": "LOCATION",
            "city": "Merrick",
            "state": "NY",
            "postal_code": "115664770",
            "country_code": "US",
            "telephone_number": "516-546-5000",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "215 Rockaway Tpke",
            "address_purpose": "LOCATION",
            "city": "Lawrence",
            "state": "NY",
            "postal_code": "115591216",
            "country_code": "US",
            "telephone_number": "516-374-5024",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "196 Merrick Rd",
            "address_purpose": "LOCATION",
            "city": "Oceanside",
            "state": "NY",
            "postal_code": "115721420",
            "country_code": "US",
            "telephone_number": "516-255-8400",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "185 Merrick Rd",
            "address_purpose": "LOCATION",
            "city": "Oceanside",
            "state": "NY",
            "postal_code": "115721431",
            "country_code": "US",
            "telephone_number": "516-766-6550",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "175 Fulton Ave Ste 309",
            "address_purpose": "LOCATION",
            "city": "Hempstead",
            "state": "NY",
            "postal_code": "115503702",
            "country_code": "US",
            "telephone_number": "516-546-1370",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "155 W Merrick Rd",
            "address_purpose": "LOCATION",
            "city": "Freeport",
            "state": "NY",
            "postal_code": "115203743",
            "country_code": "US",
            "telephone_number": "516-379-3139",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1436 Broadway",
            "address_purpose": "LOCATION",
            "city": "Hewlett",
            "state": "NY",
            "postal_code": "115571405",
            "country_code": "US",
            "telephone_number": "516-497-7422",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1420 Broadway",
            "address_purpose": "LOCATION",
            "city": "Hewlett",
            "state": "NY",
            "postal_code": "115571321",
            "country_code": "US",
            "telephone_number": "516-374-8631",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "123 Grove Ave Ste 216",
            "address_purpose": "LOCATION",
            "city": "Cedarhurst",
            "state": "NY",
            "postal_code": "115162302",
            "country_code": "US",
            "telephone_number": "516-569-5200",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1200 W Broadway Unit 5",
            "address_purpose": "LOCATION",
            "city": "Hewlett",
            "state": "NY",
            "postal_code": "115571913",
            "country_code": "US",
            "telephone_number": "516-887-7000",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "10 E Merrick Rd Ste 207",
            "address_purpose": "LOCATION",
            "city": "Valley Stream",
            "state": "NY",
            "postal_code": "115805800",
            "country_code": "US",
            "telephone_number": "516-256-2017",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "ICAHN SCHOOL OF MEDICINE AT MOUNT SINAI",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-05-31",
        "last_updated": "2018-05-31",
        "status": "A",
        "authorized_official_last_name": "GRESHAM",
        "authorized_official_first_name": "ALICIA",
        "authorized_official_title_or_position": "VP OF NETWORK OPERATIONS",
        "authorized_official_telephone_number": "212-659-9038"
    },
    "taxonomies": [
        {
            "code": "103TB0200X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychologist, Cognitive & Behavioral",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207RC0000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "207RH0003X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine, Hematology & Oncology",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207V00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Obstetrics & Gynecology",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207VM0101X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Obstetrics & Gynecology, Maternal & Fetal Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207ZC0006X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Pathology, Clinical Pathology",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2080N0001X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Pediatrics, Neonatal-Perinatal Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "208100000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physical Medicine & Rehabilitation",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2084B0040X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychiatry & Neurology, Behavioral Neurology & Neuropsychiatry",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2085R0001X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Radiology, Radiation Oncology",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2085R0202X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Radiology, Diagnostic Radiology",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "208600000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Surgery",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "208M00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Hospitalist",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "MOUNT SINAI DOCTORS SOUTH NASSAU",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Oceanside, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 31, 2018; 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.