NPIMap

Individual provider Active NPI

Derrick Tolbert-Walker, MD

  • Family Medicine Physician
  • New York, NY
National Provider Identifier
1609884394
Registry record updated Jan 22, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
203716 Issued in NY
Practice address
603 W 148TH St
7B
New York, NY 10031-3130
Phone
(917) 239-0168
Fax
(212) 245-0915
NPI assigned
Aug 4, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 22, 2015

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 203716 NY Primary

Addresses

Primary practice location

603 W 148TH St
7B
New York, NY 10031-3130

Mailing address

603 W 148TH St
7B
New York, NY 10031-3130
Phone (917) 239-0168

Other identifiers 1

IdentifierTypeStateIssuer
01714332MedicaidNY

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
I20040506001600 NY Practitioner - Family Practice 2860481769 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Temple University School of Medicine, 1991
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
NYU Langone HospitalsGroup PAC ID 4981515699, 245 clinicians

Practice addresses (Care Compare)

301 E 17TH St
New York, NY 10003-3804
Phone (212) 598-2454

Hospital & facility affiliations

  • NYU Langone Hospitals Hospital, New York, NY, CCN 330214

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Project Renewal Inc CurrentSince Dec 20, 2006 Accepting new patients
Yoav Borsuk MD PC CurrentSince Jan 1, 2015 Accepting new patients
NYU Langone Hospitals CurrentSince Jan 17, 2017 Accepting new patients
NYU Langone Hospitals CurrentSince Jan 17, 2017 Accepting new patients
Project Renewal Inc CurrentSince Dec 20, 2006 Accepting new patients
NYU Langone Hospitals Current Accepting new patients
Project Renewal Inc Past Accepting new patients
North General Physician Services PLLC PastSince Jul 1, 2006 Accepting new patients

Locations

200 Varick St
New York, NY 10014
Phone (212) 620-0340

200 Varick St
Fl 9
New York, NY 10014
Phone (212) 620-0340

225 E 45th St
#2
New York, NY 10017

301 E 17th St
New York, NY 10003
Phone (212) 460-0125

225 E 45th St
New York, NY 10017
Phone (212) 661-8934

200 Varick St
#9
New York, NY 10014
Phone (212) 620-0340

167 Madison Ave
Rm 605
New York, NY 10016
Phone (212) 979-8880

Networks

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

Interoperability endpoints

  • Direct secure messaging: dtolbertwalker132355@nyumc.direct-ci.com

Organizations & group practices 8

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 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": "1154649600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1421884800000",
    "number": "1609884394",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "603 W 148TH ST",
            "address_2": "7B",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100313130",
            "telephone_number": "917-239-0168",
            "fax_number": "212-245-0915"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "603 W 148TH ST",
            "address_2": "7B",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100313130",
            "telephone_number": "917-239-0168",
            "fax_number": "212-245-0915"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TOLBERT-WALKER",
        "first_name": "DERRICK",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-04",
        "last_updated": "2015-01-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NY",
            "license": "203716",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01714332",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

Verify at the official NPI Registry.