Individual provider Active NPI

Ida K Altshuler, M.D.

  • Neurology Physician
  • Staten Island, NY
National Provider Identifier
1497720536
Registry record updated Apr 25, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neurology PhysicianTaxonomy code 2084N0400X
License
235960-1 Issued in NY
Practice address
27 New Dorp LN
Staten Island, NY 10306-2322
Phone
(718) 667-3597
Fax
(718) 667-3590
NPI assigned
Feb 22, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 25, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Neurology Physician 2084N0400X 235960-1 NY Primary

Addresses

Primary practice location

27 New Dorp LN
Staten Island, NY 10306-2322

Mailing address

4190 Bedford Ave
Brooklyn, NY 11229-4956
Phone (718) 667-3800

Other identifiers 1

IdentifierTypeStateIssuer
02704290MedicaidNY

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
I20051206000830 NY Practitioner - Neurology 3779503693 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Neurology
Education
Other, 1974
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Alpha Neurology,PCGroup PAC ID 5799740577, 4 clinicians

Practice addresses (Care Compare)

27 New Dorp LN
Staten Island, NY 10306-2349
Phone (718) 667-3800

Hospital & facility affiliations

  • Richmond University Medical Center Hospital, Staten Island, NY, CCN 330028

Merit-based Incentive Payment System (MIPS)

Final score
71.48 of 100Reported as apm
Quality
82.91
Promoting interoperability
5.67
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
235960-1NYMDNeurology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Alpha Neurology,PC Neurology CurrentSince Aug 15, 2005 Accepting new patients
Amboy Medical Practice PC CurrentSince Aug 16, 2022 Accepting new patients
Amboy Medical Practice PC Neurology CurrentSince Aug 16, 2022 Accepting new patients
Staten Island Physician Practice PC Past Accepting new patients

Locations

4434 Amboy Rd
Staten Island, NY 10312
Phone (718) 818-1015

27 New Dorp Ln
Staten Island, NY 10306
Phone (718) 667-3800

800 Castleton Ave
Staten Island, NY 10310
Phone (718) 354-3344

Networks

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

Interoperability endpoints

  • Direct secure messaging: ida.altshuler.1@30615.direct.athenahealth.com
  • Direct secure messaging: ida.altshuler.1@19656.direct.athenahealth.com

Organizations & group practices 4

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 1

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": "1140566400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1461542400000",
    "number": "1497720536",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4190 BEDFORD AVE",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112294956",
            "telephone_number": "718-667-3800",
            "fax_number": "718-980-9281"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "27 NEW DORP LN",
            "city": "STATEN ISLAND",
            "state": "NY",
            "postal_code": "103062322",
            "telephone_number": "718-667-3597",
            "fax_number": "718-667-3590"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ALTSHULER",
        "first_name": "IDA",
        "middle_name": "K",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-02-22",
        "last_updated": "2016-04-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084N0400X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "NY",
            "license": "235960-1",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02704290",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Staten Island, NY

Sources for this page

Verify at the official NPI Registry.