Individual provider Active NPI

Mary V. Waldron, MD

  • Infectious Disease Physician
  • New York, NY
National Provider Identifier
1477511673
Registry record updated May 14, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Infectious Disease PhysicianTaxonomy code 207RI0200X
License
184527 Issued in NY
Practice address
10 Nathan D Perlman PL
16TH Street at First Ave
New York, NY 10003-3851
Phone
(212) 420-2620
NPI assigned
May 4, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 14, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Infectious Disease Physician 207RI0200X 184527 NY Primary

Addresses

Primary practice location

10 Nathan D Perlman PL
16TH Street at First Ave
New York, NY 10003-3851

Mailing address

PO Box 32886
Hartford, CT 06150-2886
Phone (212) 256-3539

Other identifiers 1

IdentifierTypeStateIssuer
01813583MedicaidNY

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
I20040825001612 NY Practitioner - Infectious DiseasePractitioner - Internal Medicine 9739153586 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
184527NYMDInfectious Disease Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Icahn School of Medicine at Mount Sinai Current Accepting new patients
Icahn School of Medicine at Mount Sinai Infectious Disease CurrentSince Jan 1, 2016 Accepting new patients
Icahn School of Medicine at Mount Sinai CurrentSince Jan 1, 2016 Accepting new patients
Bimc Faculty Practice Past Accepting new patients
Beth Israel Medical Center Infectious Disease Past Accepting new patients

Locations

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

17 E 102nd St
New York, NY 10029
Phone (212) 241-7968

317 E 17th St
New York, NY 10003
Phone (212) 420-2390

10 Union Sq E
#3
New York, NY 10003
Phone (212) 420-4145

10 Nathan D Perlman Pl
New York, NY 10003
Phone (212) 420-2124

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

Organizations & group practices 5

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": "1146700800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1557792000000",
    "number": "1477511673",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 32886",
            "city": "HARTFORD",
            "state": "CT",
            "postal_code": "061502886",
            "telephone_number": "212-256-3539"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10 NATHAN D PERLMAN PL",
            "address_2": "16TH STREET AT FIRST AVE",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100033851",
            "telephone_number": "212-420-2620"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WALDRON",
        "first_name": "MARY",
        "middle_name": "V.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-05-04",
        "last_updated": "2019-05-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RI0200X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Infectious Disease",
            "state": "NY",
            "license": "184527",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01813583",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

Verify at the official NPI Registry.