Individual provider Active NPI

Marie-Louise Fabienne Daguilh, M.D.

  • Family Medicine Physician
  • Bronx, NY
National Provider Identifier
1598826729
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
212529 Issued in NY
Practice address
1276 Fulton Ave FL 3
Bronx, NY 10456-3402
Phone
(718) 901-8749
NPI assigned
Dec 12, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 212529 NY Primary

Addresses

Primary practice location

1276 Fulton Ave FL 3
Bronx, NY 10456-3402

Mailing address

48 Silver St
Elmont, NY 11003-3621
Phone (516) 352-2011

Other identifiers 1

IdentifierTypeStateIssuer
01958070MedicaidNY

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
I20070313000511 NY Practitioner - Family Practice 2466555305 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 1985
Medicare assignment
May accept Medicare assignment
Group practices
Montefiore Medical CenterGroup PAC ID 3779496021, 2,809 clinicians

Practice addresses (Care Compare)

111 E 210TH St
Bronx, NY 10467-2401
Phone (866) 633-8255

Hospital & facility affiliations

  • Montefiore Medical Center Hospital, Bronx, NY, CCN 330059

Merit-based Incentive Payment System (MIPS)

Final score
100 of 100Reported as group
Promoting interoperability
100
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
212529NYMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Montefiore Medical Center CurrentSince Jan 12, 2007 Accepting new patients
Montefiore Medical Center CurrentSince Jan 12, 2007 Accepting new patients
Montefiore Medical Center Past Accepting new patients
Montefiore Medical Center Past Accepting new patients

Locations

2300 Westchester Ave
Bronx, NY 10462
Phone (718) 409-8000

1650 Grand Concourse
#C
Bronx, NY 10457
Phone (718) 294-7104

1055 E Tremont Ave
Bronx, NY 10460
Phone (718) 842-8040

1650 Grand Concourse
Bronx, NY 10457
Phone (718) 294-7104

111 E 210th St
Bronx, NY 10467

2100 Bartow Ave
Bronx, NY 10475
Phone (718) 320-5300

Networks

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

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.

Hospital & facility affiliations 1

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": "1165881600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1598826729",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "48 SILVER ST",
            "city": "ELMONT",
            "state": "NY",
            "postal_code": "110033621",
            "telephone_number": "516-352-2011"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1276 FULTON AVE FL 3",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "104563402",
            "telephone_number": "718-901-8749"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAGUILH",
        "first_name": "MARIE-LOUISE",
        "middle_name": "FABIENNE",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-12-12",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NY",
            "license": "212529",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01958070",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Bronx, NY

Sources for this page

Verify at the official NPI Registry.