NPIMap

Organization Active NPI

Private Medical New York, PC

  • Internal Medicine Physician
  • New York, NY
National Provider Identifier
1487203378
Registry record updated Aug 11, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
Legal business name
PRIVATE MEDICAL NEW YORK, PC
Practice address
110 E 60TH St # 808
New York, NY 10022-1688
Phone
(917) 781-1919
Fax
(917) 722-1091
NPI assigned
Sep 4, 2019
Last updated
Aug 11, 2022By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 11, 2022

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

Authorized official

Name
Jordan Lewis Shlain, MD
Title
Ceo
Phone
(212) 473-7888

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207R00000X Primary
Pediatrics PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 208000000X

Addresses

Primary practice location

110 E 60TH St # 808
New York, NY 10022-1688

Mailing address

110 E 60TH St # 808
New York, NY 10022-1688
Phone (212) 473-7888

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
33D2209993Private Medical New York, PC110 E 60TH Street, Suite 808, New York, NY 10022Certificate of waiverJan 18, 2027

National Provider Directory

National Provider Directory

Locations

110 E 60th St
Rm 808
New York, NY 10022
Phone (212) 473-7888

110 E 59th St
#808
New York, NY 10022

Practitioners & affiliated clinicians

Practitioners 10

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1567555200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1660176000000",
    "number": "1487203378",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "110 E 60TH ST # 808",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100221688",
            "telephone_number": "212-473-7888",
            "fax_number": "212-931-1888"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "110 E 60TH ST # 808",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100221688",
            "telephone_number": "917-781-1919",
            "fax_number": "917-722-1091"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PRIVATE MEDICAL NEW YORK, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-09-04",
        "last_updated": "2022-08-11",
        "certification_date": "2022-08-11",
        "status": "A",
        "authorized_official_last_name": "SHLAIN",
        "authorized_official_first_name": "JORDAN",
        "authorized_official_middle_name": "LEWIS",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "212-473-7888",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "208000000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Pediatrics",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 11, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.