Individual provider Active NPI

Harry Smith Jeanty

  • Internal Medicine Physician
  • Bronx, NY
National Provider Identifier
1609611516
Registry record updated Jul 1, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
60-P129312-01 Issued in NY
Practice address
3518 Bainbridge Ave
Bronx, NY 10467-1402
Phone
(718) 655-1991
NPI assigned
Jul 1, 2024
Last updated
Jul 1, 2024By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 1, 2024

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 60-P129312-01 NY Primary

Addresses

Primary practice location

3518 Bainbridge Ave
Bronx, NY 10467-1402

Mailing address

600 E Crescent Ave
Upper Saddle River, NJ 07458-1846

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
I20240719003417 NY Practitioner - Family Practice 4385180876 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Ilm Medical Care PLLCGroup PAC ID 2769610989, 37 clinicians
Silver Star Medical Association of NJ PCGroup PAC ID 9234597402, 10 clinicians

Practice addresses (Care Compare)

11909 26TH Ave
Flushing, NY 11354-1022
Phone (845) 738-8770

2107 Ditmas Ave
Brooklyn, NY 11226-6903
Phone (718) 462-8100

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Ilm Medical Care PLLC CurrentSince Jun 28, 2024 Accepting new patients
Clear Choice Medical PC Internal Medicine PastSince Jul 7, 2024 Accepting new patients

Locations

600 E Crescent Ave
Ste 305
Upper Saddle River, NJ 07458

2975 Independence Ave
Bronx, NY 10463
Phone (718) 542-1700

3518 Bainbridge Ave
Bronx, NY 10467
Phone (212) 410-9047

11909 26th Ave
Flushing, NY 11354
Phone (718) 434-0600

7005 35th Ave
Jackson Hts, NY 11372
Phone (718) 424-6800

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": "1719792000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1719792000000",
    "number": "1609611516",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "600 E CRESCENT AVE",
            "city": "UPPER SADDLE RIVER",
            "state": "NJ",
            "postal_code": "074581846"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3518 BAINBRIDGE AVE",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "104671402",
            "telephone_number": "718-655-1991"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JEANTY",
        "first_name": "HARRY SMITH",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2024-07-01",
        "last_updated": "2024-07-01",
        "certification_date": "2024-07-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NY",
            "license": "60-P129312-01",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bronx, NY

Sources for this page

Verify at the official NPI Registry.