Active NPI
St Lukes-Roosevelt Hospital Center
- Internal Medicine Physician
- New York, NY
National Provider Identifier
1477958007
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Internal Medicine Physician
- Legal business name
- ST LUKES-ROOSEVELT HOSPITAL CENTER
- Practice address
- 1111 Amsterdam Avenue
New York, NY 10025 - Phone
- (212) 523-4000
- NPI assigned
- Oct 24, 2014
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Ms. Crystal Macneill
- Title
- Vice President, Cbo Director
- Phone
- (212) 731-6802
Specialties & licenses 15
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dermatology Physician | 207N00000X | |||
| Family Medicine Physician | 207Q00000X | |||
| Internal Medicine Physician | 207R00000X | Primary | ||
| Cardiovascular Disease Physician | 207RC0000X | |||
| Endocrinology, Diabetes & Metabolism Physician | 207RE0101X | |||
| Gastroenterology Physician | 207RG0100X | |||
| Infectious Disease Physician | 207RI0200X | |||
| Obstetrics & Gynecology Physician | 207V00000X | |||
| Pediatrics Physician | 208000000X | |||
| Neurology Physician | 2084N0400X | |||
| Psychiatry Physician | 2084P0800X | |||
| Nurse Practitioner | 363L00000X | |||
| Adult Health Nurse Practitioner | 363LA2200X | |||
| Psychiatric/Mental Health Nurse Practitioner | 363LP0808X | |||
| Women's Health Nurse Practitioner | 363LW0102X |
Addresses
Primary practice location
1111 Amsterdam Avenue
New York, NY 10025
Mailing address
500 7TH Ave
8TH Floor
New York, NY 10018-4502
Phone (212) 731-6870
Other names 1
- The Institute for Advanced Medicine
National Provider Directory
National Provider Directory- Tax ID family
- Im Associates of Slrhc
Other organizations with this tax ID 1
Organizations that report the same tax identification number in the National Provider Directory.
-
- Infectious Disease Physician
- New York, NY
- NPI 1720123243
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1414108800000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1414108800000",
"number": "1477958007",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "500 7TH AVE",
"address_2": "8TH FLOOR",
"city": "NEW YORK",
"state": "NY",
"postal_code": "100184502",
"telephone_number": "212-731-6870",
"fax_number": "212-731-6788"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1111 AMSTERDAM AVENUE",
"city": "NEW YORK",
"state": "NY",
"postal_code": "10025",
"telephone_number": "212-523-4000"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "ST LUKES-ROOSEVELT HOSPITAL CENTER",
"organizational_subpart": "NO",
"enumeration_date": "2014-10-24",
"last_updated": "2014-10-24",
"status": "A",
"authorized_official_last_name": "MACNEILL",
"authorized_official_first_name": "CRYSTAL",
"authorized_official_title_or_position": "VICE PRESIDENT, CBO DIRECTOR",
"authorized_official_telephone_number": "212-731-6802",
"authorized_official_name_prefix": "Ms."
},
"taxonomies": [
{
"code": "207N00000X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Dermatology",
"state": null,
"license": null,
"primary": false
},
{
"code": "207Q00000X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Family Medicine",
"state": null,
"license": null,
"primary": false
},
{
"code": "207R00000X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Internal Medicine",
"state": null,
"license": null,
"primary": true
},
{
"code": "207RC0000X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Internal Medicine, Cardiovascular Disease",
"state": null,
"license": null,
"primary": false
},
{
"code": "207RE0101X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Internal Medicine, Endocrinology, Diabetes & Metabolism",
"state": null,
"license": null,
"primary": false
},
{
"code": "207RG0100X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Internal Medicine, Gastroenterology",
"state": null,
"license": null,
"primary": false
},
{
"code": "207RI0200X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Internal Medicine, Infectious Disease",
"state": null,
"license": null,
"primary": false
},
{
"code": "207V00000X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Obstetrics & Gynecology",
"state": null,
"license": null,
"primary": false
},
{
"code": "208000000X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Pediatrics",
"state": null,
"license": null,
"primary": false
},
{
"code": "2084N0400X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Psychiatry & Neurology, Neurology",
"state": null,
"license": null,
"primary": false
},
{
"code": "2084P0800X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Psychiatry & Neurology, Psychiatry",
"state": null,
"license": null,
"primary": false
},
{
"code": "363L00000X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Nurse Practitioner",
"state": null,
"license": null,
"primary": false
},
{
"code": "363LA2200X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Nurse Practitioner, Adult Health",
"state": null,
"license": null,
"primary": false
},
{
"code": "363LP0808X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Nurse Practitioner, Psychiatric/Mental Health",
"state": null,
"license": null,
"primary": false
},
{
"code": "363LW0102X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Nurse Practitioner, Women's Health",
"state": null,
"license": null,
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"organization_name": "The Institute for Advanced Medicine",
"code": "3",
"type": "Doing Business As"
}
]
}
Other providers in New York, NY
- St Lukes Roosevelt Hospital Center
- St Lukes Roosevelt Hospital Center
- St Lukes Roosevelt Hospital Center
- St Lukes Roosevelt Hospital Center
- St Lukes Roosevelt Hospital Center
- St Lukes-Roosevelt Hospital Center
- St Lukes-Roosevelt Hospital Center
- Cindy St Price, APRN
- Marie Alberte St Surin
- St Theresa Pharmacy Corp
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 24, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.