Individual provider Active NPI

Jennifer M Walia, MD

  • Obstetrics & Gynecology Physician
  • New York, NY
National Provider Identifier
1508109620
Registry record updated Apr 25, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X
License
292107-1 Issued in NY
Practice address
234 E 85TH St FL 3
New York, NY 10028-3001
Phone
(212) 731-3232
NPI assigned
Mar 27, 2013
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 25, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics & Gynecology Physician 207V00000X 292107-1 NY Primary

Addresses

Primary practice location

234 E 85TH St FL 3
New York, NY 10028-3001

Mailing address

1 Gustave L Levy PL FL 12
New York, NY 10029-6574

Other practice location 1

465 Ocean Pkwy
Brooklyn, NY 11218-5152
Phone (718) 826-6179

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
I20180820000529 NY Practitioner - Obstetrics/Gynecology 4183973522 Reassigns benefits to 2 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
292107NYMDLicensed Practical Nurse
292107-1NYMDObstetrics & Gynecology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Icahn School of Medicine at Mount Sinai CurrentSince Jul 15, 2018 Accepting new patients
Albany Medical College Obstetrics & Gynecology CurrentSince Oct 8, 2019 Accepting new patients
Albany Medical College CurrentSince Oct 8, 2019 Accepting new patients
Albany Medical College Obstetrics & Gynecology CurrentSince Oct 8, 2019 Accepting new patients
Icahn School of Medicine at Mount Sinai Obstetrics & Gynecology CurrentSince Jul 15, 2018 Accepting new patients
Albany Medical College Obstetrics & Gynecology Current Accepting new patients

Locations

47 New Scotland Ave
Albany, NY 12208
Phone (518) 262-3773

16 New Scotland Ave
Albany, NY 12208
Phone (518) 262-4942

465 Ocean Pkwy
Brooklyn, NY 11218
Phone (212) 535-9607

234 E 85th St
Fl 3
New York, NY 10028
Phone (212) 731-3232

5 E 98th St
Fl 2
New York, NY 10029
Phone (212) 241-6551

1 Gustave L Levy Pl
Fl 12
New York, NY 10029
Phone (212) 241-1518

Interoperability endpoints

  • Direct secure messaging: jennifer.walia.1@2747.direct.athenahealth.com

Organizations & group practices 6

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.

NPI Registry JSON

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

{
    "created_epoch": "1364342400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1524614400000",
    "number": "1508109620",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 GUSTAVE L LEVY PL FL 12",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100296574"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "234 E 85TH ST FL 3",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100283001",
            "telephone_number": "212-731-3232"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "465 Ocean Pkwy",
            "address_purpose": "LOCATION",
            "city": "Brooklyn",
            "state": "NY",
            "postal_code": "112185152",
            "country_code": "US",
            "telephone_number": "718-826-6179",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WALIA",
        "first_name": "JENNIFER",
        "middle_name": "M",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-03-27",
        "last_updated": "2018-04-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "NY",
            "license": "292107-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

Verify at the official NPI Registry.