Active NPI
Christina Koizumi, M.D.
- Internal Medicine Physician
- Bronx, NY
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Internal Medicine Physician
- License
- 226420
- Practice address
- 1650 Selwyn Ave
Bronx, NY 10457-7626 - Phone
- (718) 960-1436
- Fax
- (718) 960-2054
- NPI assigned
- Sep 21, 2006
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Internal Medicine Physician | 207R00000X | 226420 | NY | Primary |
Addresses
Primary practice location
1650 Selwyn Ave
Bronx, NY 10457-7626
Mailing address
1650 Selwyn Ave
Bronx, NY 10457-7626
Phone (718) 960-1436
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 02667623 | Medicaid | NY |
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
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Internal Medicine
- Education
- Albert Einstein College of Medicine of Yeshiva University, 2000
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
1650 Grand Concourse
Bronx, NY 10457-7606
Phone (718) 992-7669
Hospital & facility affiliations
- Bronxcare Hospital Center
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 226420 | NY | MD | Internal Medicine Physician |
Practice roles (4 of 8)
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Bronxcare Health System | Current | Accepting new patients | |
| Bronxcare Health System | Internal Medicine | Current | Accepting new patients |
| Bronxcare Health System | Current | Accepting new patients | |
| Bronxcare Health System | Past | Accepting new patients |
Locations
1276 Fulton Ave
Rm 208
Bronx, NY 10456
Phone (718) 901-8918
1650 Grand Concourse
Bronx, NY 10457
Phone (718) 294-7104
1650 Selwyn Ave
Bronx, NY 10457
Phone (718) 466-8153
1650 Selwyn Ave
Fl 9
Bronx, NY 10457
Phone (718) 775-0656
Networks
- Healthfirst Medicare Network H1722
- Healthfirst Medicare Network H9678
- Healthfirst Medicare Network H3359
- Healthfirst Medicare Network H5989
Organizations & group practices 4
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.
-
- Internal Medicine Physician
- Bronx, NY
- NPI 1245390855
-
- General Practice Physician
- Bronx, NY
- NPI 1194060418
-
- Methadone Clinic
- Bronx, NY
- NPI 1801428222
-
- General Acute Care Hospital
- Bronx, NY
- NPI 1417027558
Hospital & facility affiliations 1
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- General Acute Care Hospital
- Bronx, NY
- NPI 1417027558
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1158796800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1508965336",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1650 SELWYN AVE",
"city": "BRONX",
"state": "NY",
"postal_code": "104577626",
"telephone_number": "718-960-1436",
"fax_number": "718-960-2054"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1650 SELWYN AVE",
"city": "BRONX",
"state": "NY",
"postal_code": "104577626",
"telephone_number": "718-960-1436",
"fax_number": "718-960-2054"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KOIZUMI",
"first_name": "CHRISTINA",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2006-09-21",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "207R00000X",
"taxonomy_group": "",
"desc": "Internal Medicine",
"state": "NY",
"license": "226420",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "02667623",
"state": "NY"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Bronx, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.