Individual provider Active NPI

Edward Celmer, MD

  • Internal Medicine Physician
  • Staten Island, NY
National Provider Identifier
1467563403
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
234487 Issued in NY
Practice address
355 Bard Ave
Medicine
Staten Island, NY 10310-1664
Phone
(718) 370-2870
Fax
(718) 370-3203
NPI assigned
Aug 31, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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 234487 NY Primary

Addresses

Primary practice location

355 Bard Ave
Medicine
Staten Island, NY 10310-1664

Mailing address

450 W 33Rd St
PBS 12TH Floor
New York, NY 10001-2603
Phone (212) 356-4474

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
I20050119000842 NY Practitioner - Internal Medicine 3375592199 Reassigns benefits to 1 organization
Practice locations: Brooklyn, NY; Staten Island, NY

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 1983
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

88 Old Town Rd
Staten Island, NY 10304-4212
Phone (718) 979-5000

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
HHS exclusion list flag
Flagged The directory lists this NPI on an HHS exclusion list. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
234487NYMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Amboy Medical Practice PC Internal Medicine CurrentSince Apr 1, 2012 Accepting new patients
Amboy Medical Practice PC CurrentSince Apr 1, 2012 Accepting new patients
Bridgeview Dermatology, PLLC Past Accepting new patients
Footprints Pediatric Medicine, PC PastSince May 25, 2025 Accepting new patients
Community Health Center of Richmond Inc Past Accepting new patients
Richmond University Medical Center Past Accepting new patients
Community Health Center of Richmond, Inc PastSince Jan 1, 2009 Accepting new patients
Andrew C. Przybyla, MD,PC Past Accepting new patients

Locations

4434 Amboy Rd
Staten Island, NY 10312
Phone (718) 818-1015

88 Old Town Rd
Staten Island, NY 10304
Phone (718) 979-4508

275 Castleton Ave
Staten Island, NY 10301
Phone (718) 447-2829

355 Bard Ave
Staten Island, NY 10310
Phone (718) 818-1380

Networks

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

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/GBJJAA

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1156982400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1467563403",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "450 W 33RD ST",
            "address_2": "PBS 12TH FLOOR",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100012603",
            "telephone_number": "212-356-4474",
            "fax_number": "212-356-4608"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "355 BARD AVE",
            "address_2": "MEDICINE",
            "city": "STATEN ISLAND",
            "state": "NY",
            "postal_code": "103101664",
            "telephone_number": "718-370-2870",
            "fax_number": "718-370-3203"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CELMER",
        "first_name": "EDWARD",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-31",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NY",
            "license": "234487",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Staten Island, NY

Sources for this page

Verify at the official NPI Registry.