Individual provider Active NPI

Mohanambal Gounder, MD

  • Internal Medicine Physician
  • Roosevelt Island, NY
National Provider Identifier
1548316664
Registry record updated Mar 7, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
14544101 Issued in NY
Practice address
1 Main St
Roosevelt Island, NY 10044-0052
Phone
(914) 381-8900
NPI assigned
Jan 25, 2007
Last updated
Mar 7, 2023By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 7, 2023

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 14544101 NY Primary

Addresses

Primary practice location

1 Main St
Roosevelt Island, NY 10044-0052

Mailing address

1 Main St
Roosevelt Island, NY 10044-0052
Phone (914) 381-8900

Other identifiers 1

IdentifierTypeStateIssuer
14544101OtherNYNYS LICENSE

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
I20191028002800 NY Practitioner - Internal MedicinePractitioner - Hospice/Palliative CarePractitioner - Hematology/Oncology 7012249808 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
14544101NYMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
New York City Health and Hospitals Corporation Internal Medicine Current Accepting new patients
New York City Health and Hospitals Corporation CurrentSince Jul 31, 2019 Accepting new patients
New York City Health and Hospitals Corporation Internal Medicine CurrentSince Jul 31, 2019 Accepting new patients

Locations

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

50 Water St
Fl 3
New York, NY 10004

1752 Park Ave
New York, NY 10035
Phone (646) 686-0000

1 Main St
Roosevelt Island, NY 10044
Phone (212) 318-4242

Interoperability endpoints

  • Direct secure messaging: mgounder1175277@nychhc.direct-ci.com

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1169683200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1678147200000",
    "number": "1548316664",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 MAIN ST",
            "city": "ROOSEVELT ISLAND",
            "state": "NY",
            "postal_code": "100440052",
            "telephone_number": "914-381-8900"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 MAIN ST",
            "city": "ROOSEVELT ISLAND",
            "state": "NY",
            "postal_code": "100440052",
            "telephone_number": "914-381-8900"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GOUNDER",
        "first_name": "MOHANAMBAL",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-01-25",
        "last_updated": "2023-03-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NY",
            "license": "14544101",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NYS LICENSE",
            "identifier": "14544101",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Roosevelt Island, NY

Sources for this page

Verify at the official NPI Registry.