Individual provider Active NPI

Ellen Birenbaum, MD

  • Internal Medicine Physician
  • New York, NY
National Provider Identifier
1447220736
Registry record updated Aug 17, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
150923 Issued in NY
Practice address
10 Union Square E
New York, NY 10003
Phone
(212) 420-3494
NPI assigned
Jan 26, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 17, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 150923 NY Primary

Addresses

Primary practice location

10 Union Square E
New York, NY 10003

Mailing address

PO Box 95000-2433
Philadelphia, PA 19195-2433
Phone (212) 420-2000

Other identifiers 1

IdentifierTypeStateIssuer
00806551MedicaidNY

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
I20040823001453 NY Practitioner - Internal Medicine 0547234791 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
150923NYMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Ryan-Chelsea Clinton Community Health Center CurrentSince May 26, 2015 Accepting new patients
Beth Israel Medical Center Internal Medicine Past Accepting new patients
Bimc Faculty Practice Past Accepting new patients

Locations

110 W 97th St
New York, NY 10025
Phone (212) 316-7906

645 10th Ave
New York, NY 10036
Phone (212) 265-4500

Organizations & group practices 3

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": "1138233600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1345161600000",
    "number": "1447220736",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 95000-2433",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191952433",
            "telephone_number": "212-420-2000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10 UNION SQUARE E",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "10003",
            "telephone_number": "212-420-3494"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BIRENBAUM",
        "first_name": "ELLEN",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-01-26",
        "last_updated": "2012-08-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NY",
            "license": "150923",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00806551",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

Verify at the official NPI Registry.