NPIMap

Organization Active NPI

Eastside Alliance Medical Associates, P.C.

  • Gastroenterology Physician
  • New York, NY
National Provider Identifier
1619136595
Registry record updated May 13, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gastroenterology PhysicianTaxonomy code 207RG0100X
Legal business name
EASTSIDE ALLIANCE MEDICAL ASSOCIATES, P.C.
Practice address
36 E 31St St FL 10
New York, NY 10016-6821
Phone
(212) 979-3237
Fax
(212) 979-3447
NPI assigned
Jun 5, 2008
Last updated
May 13, 2026By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 13, 2026

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

Authorized official

Name
Jennifer Boyd Baldock
Title
Officer and Authorized Official
Phone
(615) 234-5954

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Gastroenterology Physician 207RG0100X NY Primary

Addresses

Primary practice location

36 E 31St St FL 10
New York, NY 10016-6821

Mailing address

36 E 31St St FL 10
New York, NY 10016-6821
Phone (212) 979-3237

Other identifiers 1

IdentifierTypeStateIssuer
03152572MedicaidNY

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20080825000495 NY Part B Supplier - Clinic/Group Practice 3173698255 Receives reassigned benefits from 48 practitioners
Practice locations: New York, NY

National Provider Directory

National Provider Directory

Locations

227 E 19th St
Bldg D
New York, NY 10003
Phone (212) 979-3237

250 Park Ave S
Fl 8
New York, NY 10003
Phone (212) 979-3237

250 Park Ave S
Fl AVE8
New York, NY 10003

Practitioners & affiliated clinicians

Practitioners 53

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 53

NPI Registry JSON

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

{
    "created_epoch": "1212624000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1778630400000",
    "number": "1619136595",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "36 E 31ST ST FL 10",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100166821",
            "telephone_number": "212-979-3237",
            "fax_number": "212-979-3447"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "36 E 31ST ST FL 10",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100166821",
            "telephone_number": "212-979-3237",
            "fax_number": "212-979-3447"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EASTSIDE ALLIANCE MEDICAL ASSOCIATES, P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-06-05",
        "last_updated": "2026-05-13",
        "certification_date": "2026-05-13",
        "status": "A",
        "authorized_official_last_name": "BALDOCK",
        "authorized_official_first_name": "JENNIFER",
        "authorized_official_middle_name": "BOYD",
        "authorized_official_title_or_position": "OFFICER AND AUTHORIZED OFFICIAL",
        "authorized_official_telephone_number": "615-234-5954"
    },
    "taxonomies": [
        {
            "code": "207RG0100X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "NY",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "03152572",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 13, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.