Individual provider Active NPI

Robert John McConnell, M.D.

  • Endocrinology, Diabetes & Metabolism Physician
  • New York, NY
National Provider Identifier
1477610426
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Endocrinology, Diabetes & Metabolism PhysicianTaxonomy code 207RE0101X
License
124447 Issued in NY
Practice address
161 Fort Washington Ave
Room 210
New York, NY 10032-3729
Phone
(212) 305-5579
Fax
(212) 305-6878
NPI assigned
Jan 2, 2007
Sex
Male
Sole proprietor
Yes

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
Endocrinology, Diabetes & Metabolism Physician 207RE0101X 124447 NY Primary

Addresses

Primary practice location

161 Fort Washington Ave
Room 210
New York, NY 10032-3729

Mailing address

161 Fort Washington Ave
Room 210
New York, NY 10032-3729
Phone (212) 305-5579

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
I20041016000133 NY Practitioner - EndocrinologyPractitioner - Internal Medicine 1658331319 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
124447NYMDEndocrinology, Diabetes & Metabolism Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Trustees of Columbia University in the City of New York CurrentSince Jan 2, 2002 Accepting new patients
Trustees of Columbia University in the City of New York Past Accepting new patients

Locations

161 Fort Washington Ave
Rm 210
New York, NY 10032
Phone (212) 305-5579

630 W 168th St
#4
New York, NY 10032
Phone (212) 305-6387

622 W 168th St
New York, NY 10032
Phone (212) 305-4931

161 Fort Washington Ave
New York, NY 10032
Phone (212) 305-8559

Networks

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

Interoperability endpoints

  • FHIR API: https://epicproxy-pub.et1089.epichosted.com/FHIRProxy/api/FHIR/R4/
  • FHIR API: https://epicproxy-pub.et1089.epichosted.com/FHIRProxy/api/FHIR/DSTU2/

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.

NPI Registry JSON

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

{
    "created_epoch": "1167696000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1477610426",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "161 FORT WASHINGTON AVE",
            "address_2": "ROOM 210",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100323729",
            "telephone_number": "212-305-5579",
            "fax_number": "212-305-6878"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "161 FORT WASHINGTON AVE",
            "address_2": "ROOM 210",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100323729",
            "telephone_number": "212-305-5579",
            "fax_number": "212-305-6878"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCCONNELL",
        "first_name": "ROBERT",
        "middle_name": "JOHN",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-01-02",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RE0101X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Endocrinology, Diabetes & Metabolism",
            "state": "NY",
            "license": "124447",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

Verify at the official NPI Registry.