NPIMap

Organization Active NPI

Icahn School of Medicine at Mount Sinai

  • Cardiovascular Disease Physician
  • New York, NY
National Provider Identifier
1487912416
Registry record updated Jun 24, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Cardiovascular Disease PhysicianTaxonomy code 207RC0000X
Legal business name
ICAHN SCHOOL OF MEDICINE AT MOUNT SINAI
Practice address
1 Gustave L Levy PL
New York, NY 10029-6574
Phone
(212) 731-7822
Fax
(212) 731-7822
NPI assigned
Apr 27, 2012
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 24, 2015

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

Authorized official

Name
Crystal Macneill
Title
Vice President, Cbo Director
Phone
(646) 605-8112

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Cardiovascular Disease PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207RC0000X Primary
Nuclear Cardiology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207UN0901X

Addresses

Primary practice location

1 Gustave L Levy PL
New York, NY 10029-6574

Mailing address

P.O. Box 28082
New York, NY 10087-8082
Phone (212) 987-3100

Other names 1

  • Cardio Vascular Institute of Mount Sinai Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY, NJ3 enrollments

Enrollment records 3

Enrollment IDStateProvider typePAC IDDetails
O20120925000424 NY Part B Supplier - Clinic/Group Practice 2264691070 Receives reassigned benefits from 261 practitioners
O20130116000409 NY Part B Supplier - Clinic/Group Practice 2264691070 Receives reassigned benefits from 41 practitioners
Practice locations: Forest Hills, NY; Jackson Heights, NY; Jamaica, NY; Ozone Park, NY; Queens Village, NY; Rego Park, NY; Richmond Hill, NY; Ridgewood, NY…
O20131018001625 NJ Part B Supplier - Clinic/Group Practice 2264691070 Receives reassigned benefits from 19 practitioners
13 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Paramus, NJ; Teaneck, NJ; Ridgewood, NJ; Long Branch, NY; Englewood Cliffs, NJ; Englewood, NJ; Edgewater, NJ; Berkeley Heights, NJ…

Other NPIs on the same Medicare enrollment 13

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

View all 13

National Provider Directory

National Provider Directory
Tax ID family
Icahn School of Medicine at33 organizations share this tax ID, including this one

Other organizations with this tax ID 32

Organizations that report the same tax identification number in the National Provider Directory.

View all 32

Locations (25 of 33)

77 Pondfield Rd
Ste 2
Bronxville, NY 10708
Phone (914) 337-6755

9413 Flatlands Ave
Ste 101E
Brooklyn, NY 11236
Phone (412) 491-7611

7404 5th Ave
Brooklyn, NY 11209
Phone (929) 415-8856

2035 Ralph Ave
Brooklyn, NY 11234
Phone (718) 209-1072

902 Quentin Rd
Ste 602
Brooklyn, NY 11223
Phone (718) 339-4800

4023 74th St
Elmhurst, NY 11373
Phone (718) 424-0200

8708 Justice Ave
Ste 1
Elmhurst, NY 11373

19603 42nd Ave
Flushing, NY 11358
Phone (718) 281-2001

3830 Parsons Blvd
Ste 1A
Flushing, NY 11354
Phone (310) 634-5702

16806 Hillside Ave
Jamaica, NY 11432
Phone (516) 499-1846

2520 30th Ave
Fl 5
Long Island City, NY 11102
Phone (718) 808-7777

4207 30th Ave
Long Island City, NY 11103
Phone (718) 204-6667

5030 Broadway
New York, NY 10034
Phone (212) 567-9800

55 E 34th St
Fl 2
New York, NY 10016
Phone (212) 252-6171

1440 Madison Ave
Fl 1
New York, NY 10029

1190 5th Ave
Fl GP1
New York, NY 10029

425 W 59th St
Ste 9D
New York, NY 10019

177 E 87th St
Ste 502
New York, NY 10128
Phone (212) 410-6666

1468 Madison Ave
Rm 754A
New York, NY 10029

1090 Amsterdam Ave
Ste 8F
New York, NY 10025

10 Union Sq E
Ste 3A
New York, NY 10003
Phone (212) 844-8100

50 E 42nd St
Rm 407
New York, NY 10017
Phone (212) 661-7003

1111 Amsterdam Ave
#J
New York, NY 10025

3340 Broadway
New York, NY 10031
Phone (212) 234-4919

627 W 181St St
New York, NY 10033

Practitioners & affiliated clinicians

Practitioners 281

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

View all 281

NPI Registry JSON

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

{
    "created_epoch": "1335484800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1435104000000",
    "number": "1487912416",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "P.O. BOX 28082",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100878082",
            "telephone_number": "212-987-3100",
            "fax_number": "212-731-5220"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 GUSTAVE L LEVY PL",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100296574",
            "telephone_number": "212-731-7822",
            "fax_number": "212-731-7822"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ICAHN SCHOOL OF MEDICINE AT MOUNT SINAI",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-04-27",
        "last_updated": "2015-06-24",
        "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": "646-605-8112"
    },
    "taxonomies": [
        {
            "code": "207RC0000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "207UN0901X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nuclear Medicine, Nuclear Cardiology",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Cardio Vascular Institute of Mount Sinai",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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 Jun 24, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.