Individual provider Active NPI

Michael Occidental, MD

  • Clinical Pathology Physician
  • New York, NY
National Provider Identifier
1497218069
Registry record updated Nov 22, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Pathology PhysicianTaxonomy code 207ZC0006X
License
320767 Issued in NY
Practice address
222 E 41St St FL 25
New York, NY 10017-6739
Phone
(212) 263-7250
Fax
(212) 263-1683
NPI assigned
Apr 10, 2019
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 22, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Dermatopathology (Pathology) Physician 207ZD0900X 320767 NY
Clinical Pathology Physician 207ZC0006X 320767 NY Primary

Addresses

Primary practice location

222 E 41St St FL 25
New York, NY 10017-6739

Mailing address

222 E 41St St FL 25
New York, NY 10017-6739
Phone (212) 263-7250

Other practice location 1

111 E 210th St
Bronx, NY 10467-2401
Phone (718) 920-4321

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
I20240509000009 NY Practitioner - Dermatology 9032550009 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Dermatology
Education
University of Arkansas College of Medicine, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
New York UniversityGroup PAC ID 1355232422, 5,925 clinicians

Practice addresses (Care Compare)

111 Broadway
New York, NY 10006-1901
Phone (212) 263-9700

1300 Franklin Ave
Suite Ul3Aandb
Garden City, NY 11530-1886
Phone (516) 747-8900

150 55TH St
Brooklyn, NY 11220-2508
Phone (718) 630-7000

150 E 32ND St
New York, NY 10016-6058
Phone (212) 263-3049

160 E 34TH St
New York, NY 10016-4744
Phone (212) 263-7300

240 E 38TH St
New York, NY 10016-2708
Phone (212) 263-7300

259 1St St
Mineola, NY 11501-3957
Phone (516) 222-8600

297 Mineola Blvd
Mineola, NY 11501-1502
Phone (516) 294-1377

355 W 52ND St
New York, NY 10019-6239
Phone (646) 778-5555

530 1St Ave
New York, NY 10016-6402
Phone (212) 263-7300

550 1St Ave
New York, NY 10016-6402
Phone (212) 263-7300

560 1St Ave
New York, NY 10016-6402
Phone (212) 263-7300

97 Amity St
Brooklyn, NY 11201-6004
Phone (212) 598-6784

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
320767NYMDClinical Pathology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
New York University CurrentSince May 1, 2024 Accepting new patients
New York University CurrentSince May 1, 2024 Accepting new patients
New York University Medical Center PastSince Jul 7, 2024 Accepting new patients

Locations

111 E 210th St
Bronx, NY 10467

550 1st Ave
New York, NY 10016
Phone (212) 263-3293

222 E 41st St
Fl 25
New York, NY 10017
Phone (212) 263-7250

Networks

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

Interoperability endpoints

  • Direct secure messaging: moccidental299647@nyumc.direct-ci.com

Organizations & group practices 3

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.

Hospital & facility affiliations 7

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1554854400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1732233600000",
    "number": "1497218069",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "222 E 41ST ST FL 25",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100176739",
            "telephone_number": "212-263-7250",
            "fax_number": "212-263-1683"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "222 E 41ST ST FL 25",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100176739",
            "telephone_number": "212-263-7250",
            "fax_number": "212-263-1683"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "111 E 210th St",
            "address_purpose": "LOCATION",
            "city": "Bronx",
            "state": "NY",
            "postal_code": "104672401",
            "country_code": "US",
            "telephone_number": "718-920-4321",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "OCCIDENTAL",
        "first_name": "MICHAEL",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-04-10",
        "last_updated": "2024-11-22",
        "certification_date": "2024-11-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207ZD0900X",
            "taxonomy_group": "",
            "desc": "Pathology, Dermatopathology",
            "state": "NY",
            "license": "320767",
            "primary": false
        },
        {
            "code": "207ZC0006X",
            "taxonomy_group": "",
            "desc": "Pathology, Clinical Pathology",
            "state": "NY",
            "license": "320767",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

Verify at the official NPI Registry.