Custon Tafadzwa Nyabanga, M.D.

Primary specialty

Gastroenterology PhysicianTaxonomy code 207RG0100X

License

294086 Issued in NY

Practice address

10 Union SQ E
New York, NY 10003-3314

Phone

(212) 420-4015

NPI assigned

Jun 1, 2016

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

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

Specialty

Gastroenterology

Education

Clvlnd Clinic Lerner College of Med of Case WSTN RSV University, 2016

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Icahn School of Medicine at Mount SinaiGroup PAC ID 2264691070, 2,809 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Mount Sinai Beth Israel Hospital, New York, NY, CCN 330169
• Mount Sinai West Hospital, New York, NY, CCN 330046

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Networks

• Healthfirst Medicare Network H9678
• Healthfirst Medicare Network H3359
• Healthfirst Medicare Network H5989
• Healthfirst Medicare Network H1722

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.

• Icahn School of Medicine at Mount Sinai

  • Gastroenterology Physician
  • New York, NY
  • NPI 1730440777
  Medicare reassignment Care Compare group NPD
• Icahn School of Medicine at Mount Sinai

  • Eyewear Supplier
  • New York, NY
  • NPI 1760227466
  NPD
• Icahn School of Medicine at Mount Sinai

  • Obstetrics & Gynecology Physician
  • New York, NY
  • NPI 1124392212
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Beth Israel Medical Center

  • General Acute Care Hospital
  • Brooklyn, NY
  • NPI 1174689665
  Care Compare affiliation
• Beth Israel Medical Center

  • General Acute Care Hospital
  • Brooklyn, NY
  • NPI 1174768071
  Care Compare affiliation
• Beth Israel Medical Center

  • Substance Use Disorder Rehabilitation Hospital Unit
  • New York, NY
  • NPI 1770951204
  Care Compare affiliation
• St Lukes Roosevelt Hospital Center

  • General Acute Care Hospital
  • New York, NY
  • NPI 1104982917
  Care Compare affiliation
• St. Lukes Roosevelt Hospital Center

  • Methadone Clinic
  • New York, NY
  • NPI 1609476357

  Hospital

  Care Compare affiliation

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

{
    "created_epoch": "1464739200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1683676800000",
    "number": "1508214552",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 GUSTAVE L LEVY PL # 1118",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100296504"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10 UNION SQ E",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100033314",
            "telephone_number": "212-420-4015"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "550 1st Ave",
            "address_purpose": "LOCATION",
            "city": "New York",
            "state": "NY",
            "postal_code": "100166402",
            "country_code": "US",
            "telephone_number": "212-263-5506",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "NYABANGA",
        "first_name": "CUSTON",
        "middle_name": "TAFADZWA",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-06-01",
        "last_updated": "2023-05-10",
        "certification_date": "2023-05-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RG0100X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "NY",
            "license": "294086",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ny West Acupuncture and Physical Therapy PLLC
• Ny West Acupuncture PC
• Ny-Metro Medical Diagnostics PC
• Ny-Presbyterian Hospital
• Ny&NJ Ortho Spine
• Akwe Nyabera, MD
• Fayola Simone Nyack
• Margaret Kwamboka Nyambati
• Absylom Kwabena Nyamekye, M.D.
• Christabel Elinsa Nyange, MD

• Gastroenterology Physician in New York, NY
• Providers in New York, NY by specialty
• Gastroenterology Physician in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 10, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• 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.