Deena Adimoolam, MD

Primary specialty

Endocrinology, Diabetes & Metabolism PhysicianTaxonomy code 207RE0101X

License

268704 Issued in NY

Practice address

1111 Amsterdam Ave
Babcock 10TH Floor
New York, NY 10025

Phone

(212) 523-8672

NPI assigned

Apr 13, 2009

Last updated

Mar 12, 2021By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in NY, NJ2 enrollments

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 2

Specialty

Endocrinology

Education

Other, 2005

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Summit Medical Group PAGroup PAC ID 5395642276, 1,204 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: deena.adimoolam.1@2983.direct.athenahealth.com

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.

• Summit Medical Group PA

  • Multi-Specialty Clinic/Center
  • Berkeley Heights, NJ
  • NPI 1942254347
  Medicare reassignment Care Compare group NPD
• Icahn School of Medicine at Mount Sinai

  dba Surgery Department of Mount Sinai BI

  • Surgery Physician
  • New York, NY
  • NPI 1104295716
  Medicare reassignment NPD
• Icahn School of Medicine at Mount Sinai

  dba Endocrinology Division of Mount Sinai

  • Endocrinology, Diabetes & Metabolism Physician
  • New York, NY
  • NPI 1235490277
  Medicare reassignment NPD
• Icahn School of Medicine at Mount Sinai

  dba Medicine Department of Mount Sinai BI

  • Internal Medicine Physician
  • New York, NY
  • NPI 1063881787
  NPD
• Icahn School of Medicine at Mount Sinai

  dba Beth Israel Medical Group of Mount Sinai

  • Internal Medicine Physician
  • New York, NY
  • NPI 1568868834
  NPD
• Icahn School of Medicine at Mount Sinai

  dba New York Eye & Ear Optical Shop

  • Eyewear Supplier
  • New York, NY
  • NPI 1760227466
  NPD
• Summit Medical Group PA

  • Durable Medical Equipment & Medical Supplies
  • Hackensack, NJ
  • NPI 1043930555
  NPD
• St Lukes Roosevelt Hospital Center

  • Community/Retail Pharmacy
  • New York, NY
  • NPI 1821136979
  NPD (past)
• Summit Medical Group, Inc

  dba St. Elizabeth Physicians

  • Family Medicine Physician
  • Erlanger, KY
  • NPI 1750343216
  NPD (past)

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

{
    "created_epoch": "1239580800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1615507200000",
    "number": "1619110228",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1111 AMSTERDAM AVE",
            "address_2": "BABCOCK 10TH FLOOR",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100251716"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1111 AMSTERDAM AVE",
            "address_2": "BABCOCK 10TH FLOOR",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "10025",
            "telephone_number": "212-523-8672"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "19-21 Fair Lawn Ave",
            "address_purpose": "LOCATION",
            "city": "Fair Lawn",
            "state": "NJ",
            "postal_code": "074102331",
            "country_code": "US",
            "telephone_number": "201-620-3390",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ADIMOOLAM",
        "first_name": "DEENA",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2009-04-13",
        "last_updated": "2021-03-12",
        "certification_date": "2021-03-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RE0101X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Endocrinology, Diabetes & Metabolism",
            "state": "NY",
            "license": "268704",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Basim Zaki Adib, ED.D
• Srikar Adibhatla, MD
• Arzu Adiguzel, ACNP
• Othman Adil, MD
• Mohammad Amin Adileh, MBBCH
• Ellis Bella Adin
• Roni Adini-Spigelman, PHD
• Holly Ann Adinolfi, PA-C
• Peter A Adintori, MS RD CSO CDN CNSC
• Paulus Adinugraha

• Endocrinology, Diabetes & Metabolism Physician in New York, NY
• Providers in New York, NY by specialty
• Endocrinology, Diabetes & Metabolism Physician in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 12, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.