NPIMap

Organization Active NPI

Phelps Memorial Hospital Association

  • Internal Medicine Physician
  • Tarrytown, NY
National Provider Identifier
1497917983
Registry record updated Jul 20, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
155904-1 Issued in NY
Legal business name
PHELPS MEMORIAL HOSPITAL ASSOCIATION
Practice address
155 White Plains Rd
210A
Tarrytown, NY 10591-5523
Phone
(914) 269-1763
NPI assigned
Jun 26, 2008
Last updated
Jul 20, 2012By the provider in NPPES
Organization subpart
Yes
Parent organization
PHELPS MEMORIAL HOSPITAL ASSOCIATIONAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Jul 20, 2012

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

Authorized official

Name
Mr. Charles Ryke
Title
Director of Professional Billing
Phone
(914) 269-1763

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207R00000X 155904-1 NY Primary
Internal Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207R00000X 093343-1 NY
Nephrology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207RN0300X 106477 NY
Pulmonary Disease PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207RP1001X 135197-1 NY

Addresses

Primary practice location

155 White Plains Rd
210A
Tarrytown, NY 10591-5523

Mailing address

155 White Plains Rd
210A
Tarrytown, NY 10591-5523
Phone (914) 269-1763

Other names 1

  • Phelps Medical Practice Other name

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20031104000490 NY Part B Supplier - Clinic/Group Practice 1658283981 Receives reassigned benefits from 65 practitioners
6 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Croton on Hudson, NY; Sleepy Hollow, NY; Ossining, NY

Other NPIs on the same Medicare enrollment 6

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

National Provider Directory

National Provider Directory
Tax ID family
Phelps Memorial Hospita15 organizations share this tax ID, including this one
Part of
Phelps Memorial Hospita

Other organizations with this tax ID 14

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

View all 14

Locations

362 N Broadway
Sleepy Hollow, NY 10591
Phone (914) 269-1740

155 White Plains Rd
#210A
Tarrytown, NY 10591
Phone (914) 269-1763

Practitioners & affiliated clinicians

Practitioners 19

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 19

NPI Registry JSON

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

{
    "created_epoch": "1214438400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1342742400000",
    "number": "1497917983",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "155 WHITE PLAINS RD",
            "address_2": "210A",
            "city": "TARRYTOWN",
            "state": "NY",
            "postal_code": "105915523",
            "telephone_number": "914-269-1763"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "155 WHITE PLAINS RD",
            "address_2": "210A",
            "city": "TARRYTOWN",
            "state": "NY",
            "postal_code": "105915523",
            "telephone_number": "914-269-1763"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PHELPS MEMORIAL HOSPITAL ASSOCIATION",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "PHELPS MEMORIAL HOSPITAL ASSOCIATION",
        "enumeration_date": "2008-06-26",
        "last_updated": "2012-07-20",
        "status": "A",
        "authorized_official_last_name": "RYKE",
        "authorized_official_first_name": "CHARLES",
        "authorized_official_title_or_position": "DIRECTOR OF PROFESSIONAL BILLING",
        "authorized_official_telephone_number": "914-269-1763",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine",
            "state": "NY",
            "license": "155904-1",
            "primary": true
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine",
            "state": "NY",
            "license": "093343-1",
            "primary": false
        },
        {
            "code": "207RN0300X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine, Nephrology",
            "state": "NY",
            "license": "106477",
            "primary": false
        },
        {
            "code": "207RP1001X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine, Pulmonary Disease",
            "state": "NY",
            "license": "135197-1",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Phelps Medical Practice",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Tarrytown, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 20, 2012; 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.