NPIMap

Organization Active NPI

Lifespire, Inc.

  • Clinic/Center
  • New York, NY
National Provider Identifier
1497709166
Registry record updated Aug 31, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinic/CenterTaxonomy code 261Q00000X
Legal business name
LIFESPIRE, INC.
Practice address
159 E 125TH St
New York, NY 10035-1748
Phone
(212) 828-8506
Fax
(212) 876-8942
NPI assigned
May 19, 2006
Last updated
Aug 31, 2026By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 31, 2026

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

Authorized official

Name
Emilio Bonilla
Title
Cfo
Phone
(212) 741-0100

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinic/Center 261Q00000X NY Primary

Addresses

Primary practice location

159 E 125TH St
New York, NY 10035-1748

Mailing address

462 Fashion Ave FL 5
New York, NY 10018-7852
Phone (212) 741-0100

Other identifiers 2

IdentifierTypeStateIssuer
00347755MedicaidNY
01500150MedicaidNY

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040312000104 NY Part B Supplier - Clinic/Group Practice 5496644015 Receives reassigned benefits from 49 practitioners
1 other NPI on this enrollment
Practice locations: Bayside, NY; Staten Island, NY; Richmond Hill, NY; New York, NY; Jamaica, NY; Brooklyn, NY; Bronx, NY

Other NPIs on the same Medicare enrollment 1

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

National Provider Directory

National Provider Directory
Tax ID family
North Shore-Lij Medicalpc4 organizations share this tax ID, including this one

Other organizations with this tax ID 3

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

Locations

159 E 125th St
New York, NY 10035
Phone (212) 996-7381

159 E 125th St
Fl 2
New York, NY 10035
Phone (212) 360-5600

350 5th Ave
Ste 301
New York, NY 10118

Practitioners & affiliated clinicians

Practitioners 129

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 129

NPI Registry JSON

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

{
    "created_epoch": "1147996800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1788134400000",
    "number": "1497709166",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "462 FASHION AVE FL 5",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100187852",
            "telephone_number": "212-741-0100",
            "fax_number": "212-320-0342"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "159 E 125TH ST",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100351748",
            "telephone_number": "212-828-8506",
            "fax_number": "212-876-8942"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LIFESPIRE, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-19",
        "last_updated": "2026-08-31",
        "certification_date": "2026-08-31",
        "status": "A",
        "authorized_official_last_name": "BONILLA",
        "authorized_official_first_name": "EMILIO",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "212-741-0100"
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": "NY",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00347755",
            "state": "NY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01500150",
            "state": "NY"
        }
    ],
    "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 31, 2026; 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.