Active NPI
Paul Richard Gennis
- Emergency Medicine Physician
- Bronx, NY
National Provider Identifier
1619046307
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Emergency Medicine Physician
- License
- 146026
- Practice address
- 1400 Pelham Pkwy S
Bronx, NY 10461-1138 - Phone
- (718) 918-3060
- Fax
- (718) 918-4469
- NPI assigned
- Nov 7, 2006
- Last updated
- Jul 8, 2007
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Emergency Medicine Physician | 207P00000X | 146026 | NY | Primary |
Addresses
Primary practice location
1400 Pelham Pkwy S
Bronx, NY 10461-1138
Mailing address
25 Cortlandt Ave
New Rochelle, NY 10801-2005
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 01652102 | Medicaid | NY |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 146026 | NY | MD | Emergency Medicine Physician |
Networks
- Healthfirst Medicare Network H5989
- Healthfirst Medicare Network H1722
- Healthfirst Medicare Network H9678
- Healthfirst Medicare Network H3359
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1162857600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1619046307",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "25 CORTLANDT AVE",
"city": "NEW ROCHELLE",
"state": "NY",
"postal_code": "108012005"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1400 PELHAM PKWY S",
"city": "BRONX",
"state": "NY",
"postal_code": "104611138",
"telephone_number": "718-918-3060",
"fax_number": "718-918-4469"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GENNIS",
"first_name": "PAUL",
"middle_name": "RICHARD",
"name_prefix": "Dr.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-11-07",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "207P00000X",
"taxonomy_group": "",
"desc": "Emergency Medicine",
"state": "NY",
"license": "146026",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "01652102",
"state": "NY"
}
],
"endpoints": [],
"other_names": []
}Other providers in Bronx, NY
- Joseph Gennardo, RPH
- Judith A. Gennarelli, RDN
- Louis B Gennarelli, MD
- Lisa Marie Gennarini, M.D.
- Diana Gennaro, PHYSICIAN ASSISTANT
- Dylan Genouw, MD
- Genovese Drug Stores Inc (Rite Aid Pharmacy 10542)
- Genovese Drug Stores Inc (Rite Aid Pharmacy 10543)
- Genovese Drug Stores Inc (Rite Aid Pharmacy 10541)
- Genovese Drug Stores Inc (Rite Aid Pharmacy 10544)
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.