Individual provider Active NPI

Maria Pablo, M.D.

  • Internal Medicine Physician
  • Staten Island, NY
National Provider Identifier
1508963752
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
186130 Issued in NY
Practice address
460 Brielle Ave
Staten Island, NY 10314-6427
Phone
(718) 317-3267
NPI assigned
Sep 20, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 186130 NY Primary

Addresses

Primary practice location

460 Brielle Ave
Staten Island, NY 10314-6427

Mailing address

378 Melba St
Staten Island, NY 10314-5339
Phone (718) 317-3267

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
I20100709000415 NY Practitioner - Internal Medicine 6507998523 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
186130NYMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
New York City Health and Hospitals Corporation Internal Medicine CurrentSince Jan 1, 1992 Accepting new patients
New York City Health and Hospitals Corporation Internal Medicine Current Accepting new patients
New York City Health and Hospitals Corporation CurrentSince Jan 1, 1992 Accepting new patients

Locations

594 Albany Ave
Brooklyn, NY 11203
Phone (646) 694-6680

100 N Portland Ave
Brooklyn, NY 11205
Phone (718) 260-7500

50 Water St
Fl 3
New York, NY 10004

460 Brielle Ave
Staten Island, NY 10314
Phone (646) 694-6680

Organizations & group practices 3

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": "1158710400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1508963752",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "378 MELBA ST",
            "city": "STATEN ISLAND",
            "state": "NY",
            "postal_code": "103145339",
            "telephone_number": "718-317-3267"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "460 BRIELLE AVE",
            "city": "STATEN ISLAND",
            "state": "NY",
            "postal_code": "103146427",
            "telephone_number": "718-317-3267"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PABLO",
        "first_name": "MARIA",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-09-20",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NY",
            "license": "186130",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Staten Island, NY

Sources for this page

Verify at the official NPI Registry.