Individual provider Active NPI

Molly Fisher, D.O.

  • Nephrology Physician
  • Bronx, NY
National Provider Identifier
1467749143
Registry record updated Mar 18, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nephrology PhysicianTaxonomy code 207RN0300X
License
55571 Issued in CT
Practice address
3400 Bainbridge Ave
Bronx, NY 10467-2404
Phone
(718) 920-5442
Fax
(718) 652-8384
NPI assigned
Jul 1, 2011
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 18, 2019

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Nephrology Physician 207RN0300X 55571 CT Primary

Addresses

Primary practice location

3400 Bainbridge Ave
Bronx, NY 10467-2404

Mailing address

30 Shelburne Rd
Department of Medicine
Stamford, CT 06902-3628
Phone (203) 276-7485

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
I20180530000210 NY Practitioner - Nephrology 4688952815 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nephrology
Education
Other, 2011
Medicare assignment
May accept Medicare assignment
Telehealth
Offers telehealth services
Group practices
Montefiore Medical CenterGroup PAC ID 3779496021, 2,809 clinicians

Practice addresses (Care Compare)

111 E 210TH St
Bronx, NY 10467-2401
Phone (718) 920-4321

Hospital & facility affiliations

  • FMS-Eastchester Dialysis facility, Bronx, NY, CCN 332613
  • Cassena Kidney Care at Morningside Dialysis facility, Bronx, NY, CCN 332797
  • Montefiore Medical Center Hospital, Bronx, NY, CCN 330059

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
55571CTMDNephrology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Montefiore Medical Center CurrentSince Apr 18, 2018 Accepting new patients
Montefiore Medical Center Nephrology CurrentSince Apr 18, 2018 Accepting new patients

Locations

1 Hospital Plz
Stamford, CT 06902
Phone (203) 276-4925

1180 Morris Park Ave
Bronx, NY 10461
Phone (718) 829-1500

111 E 210th St
Bronx, NY 10467

3444 Kossuth Ave
Bronx, NY 10467
Phone (718) 920-2273

Networks

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

Interoperability endpoints

  • Direct secure messaging: mfisher@montefioredirect.com

Organizations & group practices 2

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.

Hospital & facility affiliations 3

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": "1309478400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1552867200000",
    "number": "1467749143",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "30 SHELBURNE RD",
            "address_2": "DEPARTMENT OF MEDICINE",
            "city": "STAMFORD",
            "state": "CT",
            "postal_code": "069023628",
            "telephone_number": "203-276-7485",
            "fax_number": "203-276-7368"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3400 BAINBRIDGE AVE",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "104672404",
            "telephone_number": "718-920-5442",
            "fax_number": "718-652-8384"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FISHER",
        "first_name": "MOLLY",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-07-01",
        "last_updated": "2019-03-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207RN0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Nephrology",
            "state": "CT",
            "license": "55571",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bronx, NY

Sources for this page

Verify at the official NPI Registry.