Individual provider Active NPI

Michael Lawrence Rinke, M.D., PH.D.

  • Pediatrics Physician
  • Bronx, NY
National Provider Identifier
1598969040
Registry record updated Sep 23, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
D70445 Issued in MD
Practice address
3411 Wayne Ave
Room 801
Bronx, NY 10467-2509
Phone
(718) 741-2524
NPI assigned
Jun 11, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 23, 2016

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 22173 MD
Pediatrics Physician 208000000X D70445 MD Primary

Addresses

Primary practice location

3411 Wayne Ave
Room 801
Bronx, NY 10467-2509

Mailing address

3411 Wayne Ave
Room 801
Bronx, NY 10467-2509
Phone (718) 741-2524

Other identifiers 1

IdentifierTypeStateIssuer
03603725MedicaidNY

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
I20130905000025 NY Practitioner - Pediatric Medicine 6800080086 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
22173MDMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Montefiore Medical Center CurrentSince Jun 21, 2013 Accepting new patients
Montefiore Medical Center Pediatrics CurrentSince Jun 21, 2013 Accepting new patients
Montefiore Medical Center Past Accepting new patients

Locations

111 E 210th St
Bronx, NY 10467

3411 Wayne Ave
Rm 801
Bronx, NY 10467
Phone (718) 741-2524

Networks

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

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1181520000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1474588800000",
    "number": "1598969040",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3411 WAYNE AVE",
            "address_2": "ROOM 801",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "104672509",
            "telephone_number": "718-741-2524"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3411 WAYNE AVE",
            "address_2": "ROOM 801",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "104672509",
            "telephone_number": "718-741-2524"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RINKE",
        "first_name": "MICHAEL",
        "middle_name": "LAWRENCE",
        "name_prefix": "Dr.",
        "credential": "M.D., PH.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-06-11",
        "last_updated": "2016-09-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "MD",
            "license": "22173",
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "MD",
            "license": "D70445",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "03603725",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Bronx, NY

Sources for this page

Verify at the official NPI Registry.