Active NPI
Nana A Makalatia, MD
- Geriatric Medicine (Internal Medicine) Physician
- New York, NY
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Geriatric Medicine (Internal Medicine) Physician
- License
- 240839
- Practice address
- 5141 Broadway
New York, NY 10034 - Phone
- (212) 305-5138
- Fax
- (212) 305-2843
- NPI assigned
- Aug 20, 2006
- Last updated
- Jul 21, 2022
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 5
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Internal Medicine Physician | 207R00000X | 230101 | MA | |
| Internal Medicine Physician | 207R00000X | 240839 | NY | |
| Geriatric Medicine (Internal Medicine) Physician | 207RG0300X | 230101 | MA | |
| Geriatric Medicine (Internal Medicine) Physician | 207RG0300X | 240839 | NY | Primary |
| Hospitalist Physician | 208M00000X | 240839 | NY |
Addresses
Primary practice location
5141 Broadway
New York, NY 10034
Mailing address
4405 Broadway
New York, NY 10040-4014
Phone (212) 740-2020
Other practice location 1
4444 Stockbridge Road
Great Barrington, MA 01230
Phone (413) 528-8580
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 110101349A | Medicaid | MA |
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
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 240839 | NY | MD | Hospitalist Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Trustees of Columbia University in the City of New York | Internal Medicine | Current | Accepting new patients |
| Trustees of Columbia University in the City of New York | Internal Medicine | Current | Accepting new patients |
| Trustees of Columbia University in the City of New York | Internal Medicine | Current | Accepting new patients |
| Trustees of Columbia University in the City of New York | Internal Medicine | Current | Accepting new patients |
| Trustees of Columbia University in the City of New York | Internal Medicine | Current | Accepting new patients |
Locations
161 Fort Washington Ave
New York, NY 10032
Phone (212) 305-8559
5141 Broadway
New York, NY 10034
Phone (212) 932-4000
622 W 168th St
New York, NY 10032
Phone (212) 305-4931
630 W 168th St
#4
New York, NY 10032
Phone (212) 305-6387
Interoperability endpoints
- https://epicproxy-pub.et1089.epichosted.com/FHIRProxy/api/FHIR/DSTU2/
- https://epicproxy-pub.et1089.epichosted.com/FHIRProxy/api/FHIR/R4/
Organizations & group practices 5
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.
-
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- New York, NY
- NPI 1437176047
-
- Surgery Physician
- New York, NY
- NPI 1508266347
Internal Medicine
-
- Internal Medicine Physician
- Fort Lee, NJ
- NPI 1982993184
NY
-
- Internal Medicine Physician
- New York, NY
- NPI 1699289488
-
- Internal Medicine Physician
- New York, NY
- NPI 1861907321
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1156032000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1658361600000",
"number": "1578678256",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4405 BROADWAY",
"city": "NEW YORK",
"state": "NY",
"postal_code": "100404014",
"telephone_number": "212-740-2020"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5141 BROADWAY",
"city": "NEW YORK",
"state": "NY",
"postal_code": "10034",
"telephone_number": "212-305-5138",
"fax_number": "212-305-2843"
}
],
"practiceLocations": [
{
"address_1": "4444 Stockbridge Road",
"address_purpose": "LOCATION",
"city": "Great Barrington",
"state": "MA",
"postal_code": "01230",
"country_code": "US",
"telephone_number": "413-528-8580",
"fax_number": "413-528-8583",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "MAKALATIA",
"first_name": "NANA",
"middle_name": "A",
"name_prefix": "Dr.",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-08-20",
"last_updated": "2022-07-21",
"certification_date": "2022-07-21",
"status": "A"
},
"taxonomies": [
{
"code": "207R00000X",
"taxonomy_group": "",
"desc": "Internal Medicine",
"state": "MA",
"license": "230101",
"primary": false
},
{
"code": "207R00000X",
"taxonomy_group": "",
"desc": "Internal Medicine",
"state": "NY",
"license": "240839",
"primary": false
},
{
"code": "207RG0300X",
"taxonomy_group": "",
"desc": "Internal Medicine, Geriatric Medicine",
"state": "MA",
"license": "230101",
"primary": false
},
{
"code": "207RG0300X",
"taxonomy_group": "",
"desc": "Internal Medicine, Geriatric Medicine",
"state": "NY",
"license": "240839",
"primary": true
},
{
"code": "208M00000X",
"taxonomy_group": "",
"desc": "Hospitalist",
"state": "NY",
"license": "240839",
"primary": false
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "110101349A",
"state": "MA"
}
],
"endpoints": [],
"other_names": []
}
Other providers in New York, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; 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.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.