Individual provider Active NPI

Ileana Maldonado, M.D.

  • Anesthesiology Physician
  • Forest Hills, NY
National Provider Identifier
1538355151
Registry record updated Mar 5, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
License
261206-1 Issued in NY
Practice address
10440 Queens Blvd
Apt 4C
Forest Hills, NY 11375-3637
Phone
(347) 622-3385
NPI assigned
Sep 18, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 5, 2015

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X NY
Student in an Organized Health Care Education/Training Program 390200000X 26566 PR
Anesthesiology Physician 207L00000X 261206-1 NY Primary
Anesthesiology Physician 207L00000X MD447273 PA

Addresses

Primary practice location

10440 Queens Blvd
Apt 4C
Forest Hills, NY 11375-3637

Mailing address

10440 Queens Blvd
Apt 4C
Forest Hills, NY 11375-3637
Phone (347) 622-3385

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA
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
I20150417001459 PA Practitioner - Anesthesiology 8224201694 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Anesthesiology
Education
University Central del Caribe Escuela de Medicina, 2007
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
North American Partners in Anesthesia, Pennsylvania , LLCGroup PAC ID 7517960834, 302 clinicians

Practice addresses (Care Compare)

1600 E High St
Pottstown Memorial Medical Center
Pottstown, PA 19464-5008
Phone (610) 327-7008

206 E Brown St
East Stoudsburg, PA 18301-3006
Phone (570) 421-4000

8835 Germantown Ave
Phila, PA 19118-2718
Phone (215) 248-8227

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
261206-1NYMDAnesthesiology Physician
MD447273PAMDAnesthesiology Physician
26566PRMDStudent in an Organized Health Care Education/Training Program

Practice roles

OrganizationSpecialtyStatusNew patients
North American Partners in Anesthesia, Pennsylvania , LLC Anesthesiology CurrentSince Apr 1, 2015 Accepting new patients
University Physicians of Brooklyn, Inc Anesthesiology Past Accepting new patients

Locations

68 S Service Rd
Ste 350
Melville, NY 11747
Phone (516) 945-3107

206 E Brown St
East Stroudsburg, PA 18301
Phone (570) 420-4951

8835 Germantown Ave
Philadelphia, PA 19118
Phone (215) 248-8227

Organizations & group practices 2

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.

Hospital & facility affiliations 3

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

NPI Registry JSON

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

{
    "created_epoch": "1190073600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1425513600000",
    "number": "1538355151",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10440 QUEENS BLVD",
            "address_2": "APT 4C",
            "city": "FOREST HILLS",
            "state": "NY",
            "postal_code": "113753637",
            "telephone_number": "347-622-3385"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10440 QUEENS BLVD",
            "address_2": "APT 4C",
            "city": "FOREST HILLS",
            "state": "NY",
            "postal_code": "113753637",
            "telephone_number": "347-622-3385"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MALDONADO",
        "first_name": "ILEANA",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-09-18",
        "last_updated": "2015-03-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "NY",
            "license": null,
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "PR",
            "license": "26566",
            "primary": false
        },
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "NY",
            "license": "261206-1",
            "primary": true
        },
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "PA",
            "license": "MD447273",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Forest Hills, NY

Sources for this page

Verify at the official NPI Registry.