NPIMap

Organization Active NPI

Mount Sinai School of Medicine

  • Psychiatry Physician
  • Hempstead, NY
National Provider Identifier
1508333956
Registry record updated Jan 11, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
Legal business name
MOUNT SINAI SCHOOL OF MEDICINE
Practice address
175 Fulton Ave Ste 309
Hempstead, NY 11550-3702
Phone
(516) 485-5710
Fax
(516) 485-4225
NPI assigned
Oct 24, 2018
Last updated
Jan 11, 2019By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 11, 2019

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

Authorized official

Name
Alicia Gresham
Title
VP Network Operations
Phone
(212) 659-9038

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X NU
Psychologist 103T00000X NU
Psychiatric/Mental Health Registered Nurse 163WP0808X NU
Psychiatry Physician 2084P0800X NU Primary

Addresses

Primary practice location

175 Fulton Ave Ste 309
Hempstead, NY 11550-3702

Mailing address

1 Healthy Way
Oceanside, NY 11572-1551

Other practice location 1

2277 Grand Ave
Baldwin, NY 11510-3148
Phone (516) 377-5400

Other practice location 2

1 Healthy Way
Oceanside, NY 11572-1551
Phone (516) 632-3937

Other names 1

  • Mount Sinai Marathon Medical - Behavioral Health Other name

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20130712000368 NY Part B Supplier - Clinic/Group Practice 6406096544 Receives reassigned benefits from 385 practitioners
15 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Lynbrook, NY; Long Beach, NY; Manhasset, NY; Merrick, NY; New York, NY; Oceanside, NY; Rockville Centre, NY; Valley Stream, NY…

Other NPIs on the same Medicare enrollment 15

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

View all 15

National Provider Directory

National Provider Directory

Locations

2280 Grand Ave
Ste 208
Baldwin, NY 11510
Phone (516) 623-4800

250 Fulton Ave
Fl 1
Hempstead, NY 11550
Phone (516) 255-8400

750 Montauk Hwy
West Islip, NY 11795
Phone (631) 376-1010

Practitioners & affiliated clinicians

Practitioners 374

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 374

NPI Registry JSON

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

{
    "created_epoch": "1540339200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1547164800000",
    "number": "1508333956",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 HEALTHY WAY",
            "city": "OCEANSIDE",
            "state": "NY",
            "postal_code": "115721551"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "175 FULTON AVE STE 309",
            "city": "HEMPSTEAD",
            "state": "NY",
            "postal_code": "115503702",
            "telephone_number": "516-485-5710",
            "fax_number": "516-485-4225"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2277 Grand Ave",
            "address_purpose": "LOCATION",
            "city": "Baldwin",
            "state": "NY",
            "postal_code": "115103148",
            "country_code": "US",
            "telephone_number": "516-377-5400",
            "fax_number": "516-377-5490",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1 Healthy Way",
            "address_purpose": "LOCATION",
            "city": "Oceanside",
            "state": "NY",
            "postal_code": "115721551",
            "country_code": "US",
            "telephone_number": "516-632-3937",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "MOUNT SINAI SCHOOL OF MEDICINE",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-10-24",
        "last_updated": "2019-01-11",
        "status": "A",
        "authorized_official_last_name": "GRESHAM",
        "authorized_official_first_name": "ALICIA",
        "authorized_official_title_or_position": "VP NETWORK OPERATIONS",
        "authorized_official_telephone_number": "212-659-9038"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "163WP0808X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Psychiatric/Mental Health",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Mount Sinai Marathon Medical - Behavioral Health",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Hempstead, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 11, 2019; 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.