NPIMap

Organization Active NPI

Maiden Lane Medical, PLLC

  • Gynecology Physician
  • New York, NY
National Provider Identifier
1497291074
Registry record updated Jan 6, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gynecology PhysicianTaxonomy code 207VG0400X
License
220289 Issued in NY
Legal business name
MAIDEN LANE MEDICAL, PLLC
Practice address
90 Maiden LN
Third Floor
New York, NY 10038-4831
Phone
(646) 290-9560
Fax
(212) 532-4362
NPI assigned
Jan 6, 2017
Last updated
Jan 6, 2017By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 6, 2017

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

Authorized official

Name
Kenneth Levey, MDNPI 1942294350
Title
President
Phone
(646) 290-9560

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Gynecology Physician 207VG0400X 220289 NY Primary

Addresses

Primary practice location

90 Maiden LN
Third Floor
New York, NY 10038-4831

Mailing address

90 Maiden LN
Third Floor
New York, NY 10038-4831
Phone (646) 290-9560

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20170420001654 NY Part B Supplier - Clinic/Group Practice 2365728698 Receives reassigned benefits from 25 practitioners
Practice locations: New York, NY

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
33D2046630Maiden Lane Medical Pllcr90 Maiden Lane, Third Floor, New York, NY 10038ComplianceJul 31, 2026

National Provider Directory

National Provider Directory
Tax ID family
Maiden Lane Medical PLLC2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

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

Locations

503 5th Ave
Ste 2
Brooklyn, NY 11215

7206 Narrows Ave
Ste 404
Brooklyn, NY 11209

110 E 60th St
Rm 903
New York, NY 10022
Phone (649) 290-9560

110 E 60th St
Ste 90
New York, NY 10022

18 E 41st St
Fl 2
New York, NY 10017
Phone (646) 290-9560

18 E 41st St
Ste 300
New York, NY 10017

415 W Broadway
#5
New York, NY 10012

415 W Broadway
Fl 5
New York, NY 10012
Phone (646) 290-9560

90 Maiden Ln
New York, NY 10038
Phone (646) 290-9560

90 Maiden Ln
Fl 3
New York, NY 10038
Phone (646) 290-9560

90 Maiden Ln
Fl Third
New York, NY 10038
Phone (646) 290-9560

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/EEDBDA

Ownership & related parties

Subparts reporting this organization as parent 1

Organizations that report themselves as subparts in NPPES and name this organization, in the same state, as their parent.

Practitioners & affiliated clinicians

Practitioners 31

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.

View all 31

NPI Registry JSON

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

{
    "created_epoch": "1483660800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1483660800000",
    "number": "1497291074",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "90 MAIDEN LN",
            "address_2": "THIRD FLOOR",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100384831",
            "telephone_number": "646-290-9560",
            "fax_number": "212-532-4362"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "90 MAIDEN LN",
            "address_2": "THIRD FLOOR",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100384831",
            "telephone_number": "646-290-9560",
            "fax_number": "212-532-4362"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MAIDEN LANE MEDICAL, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-01-06",
        "last_updated": "2017-01-06",
        "status": "A",
        "authorized_official_last_name": "LEVEY",
        "authorized_official_first_name": "KENNETH",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "646-290-9560",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207VG0400X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology, Gynecology",
            "state": "NY",
            "license": "220289",
            "primary": true
        }
    ],
    "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 Jan 6, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • 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.