NPIMap

Individual provider Active NPI

Marie Sedlackova, M.D.

  • Geriatric Medicine (Internal Medicine) Physician
  • New York, NY
National Provider Identifier
1578589164
Registry record updated Jul 7, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Geriatric Medicine (Internal Medicine) PhysicianTaxonomy code 207RG0300X
License
193561 Issued in NY
Practice address
318 E 23Rd St
New York, NY 10010-4713
Phone
(212) 598-6429
Fax
(212) 598-6512
NPI assigned
Jul 15, 2006
Last updated
Jul 7, 2021By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 7, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 193561-1 NY
Geriatric Medicine (Internal Medicine) Physician 207RG0300X 193561 NY Primary

Addresses

Primary practice location

318 E 23Rd St
New York, NY 10010-4713

Mailing address

318 E 23Rd St
New York, NY 10010-4713
Phone (212) 598-6429

Other identifiers 1

IdentifierTypeStateIssuer
193561OtherHIP

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20080416000374 NY Practitioner - Internal MedicinePractitioner - Hospice/Palliative CarePractitioner - Geriatric Medicine 0840378873 Reassigns benefits to 1 organization
Practice locations: New York, NY

Care Compare profile

Medicare Care Compare
Specialty
Internal MedicineAlso: Geriatric Medicine, Hospice/Palliative Care
Education
Other, 1989
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
New York UniversityGroup PAC ID 1355232422, 5,925 clinicians

Practice addresses (Care Compare)

111 Broadway
New York, NY 10006-1901
Phone (212) 263-9700

324 E 23Rd St
New York, NY 10010-4701
Phone (212) 589-6000

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
90.8 of 100Reported as group
Quality
91.79
Promoting interoperability
100
Improvement activities
40
Cost
75.18

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
193561-1NYMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
New York University Internal Medicine CurrentSince Jun 1, 2013 Accepting new patients
New York University Internal Medicine CurrentSince Jun 1, 2013 Accepting new patients
New York University Past Accepting new patients

Locations

160 E 34th St
New York, NY 10016
Phone (212) 731-5180

320 E 23rd St
New York, NY 10010
Phone (212) 598-6500

530 1st Ave
#4J
New York, NY 10016
Phone (212) 263-7043

Networks

  • Healthfirst Medicare Network H5989
  • Healthfirst Medicare Network H1722
  • Healthfirst Medicare Network H9678
  • Healthfirst Medicare Network H3359

Interoperability endpoints

  • Direct secure messaging: msedlackova43772@nyumc.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.

Hospital & facility affiliations 7

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": "1152921600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1625616000000",
    "number": "1578589164",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "318 E 23RD ST",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100104713",
            "telephone_number": "212-598-6429",
            "fax_number": "212-598-6512"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "318 E 23RD ST",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100104713",
            "telephone_number": "212-598-6429",
            "fax_number": "212-598-6512"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SEDLACKOVA",
        "first_name": "MARIE",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-07-15",
        "last_updated": "2021-07-07",
        "certification_date": "2021-07-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NY",
            "license": "193561-1",
            "primary": false
        },
        {
            "code": "207RG0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Geriatric Medicine",
            "state": "NY",
            "license": "193561",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HIP",
            "identifier": "193561",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

Verify at the official NPI Registry.