Ethan Abbott, DO
Individual provider Active NPI Emergency Medicine Physician · Bronx, NY
NPI 1619252202 · NPPES record last updated Aug 8, 2014
Key facts
- NPI
- 1619252202
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Emergency Medicine Physician 207P00000X
- License
- 268067 (NY)
- Practice address
- 1825 Eastchester Road
Montefiore, Weiler Hospital
Bronx, NY 10461 - Phone
- (718) 904-3333
- NPI assigned
- Oct 15, 2011
- Sex
- Male
- Sole proprietor
- Yes
Organizations & group practices 6
Hospital & facility affiliations 7
Medicare Care Compare profile
- Specialty
- Emergency Medicine
- Education
- University of New England, College of Osteo Medicine, 2010
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Icahn School of Medicine at Mount Sinai
Practice addresses (Care Compare)
1468 Madison Ave
New York, NY 10029-6508
Phone (212) 987-3100
Hospital & facility affiliations
- Mount Sinai Hospital
- Mount Sinai South Nassau
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in NY
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20131003000015 | NY | Practitioner - Emergency Medicine | 6608000799 | Reassigns benefits to 4 organizations |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Osteopathy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 268067 | NY | MD | Emergency Medicine Physician |
Practice roles (6 of 10)
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Icahn School of Medicine at Mount Sinai | Emergency Medicine | Current |
Accepting new patients |
| Icahn School of Medicine at Mount Sinai | Current | Accepting new patients | |
| Fpa Hospital Based | Current |
Accepting new patients | |
| Fpa Hospital Based | Emergency Medicine | Current |
Accepting new patients |
| Fpa Hospital Based | Current | Accepting new patients | |
| Icahn School of Medicine at Mount Sinai | Emergency Medicine | Current |
Accepting new patients |
Locations
2510 30th Ave
Long Island City, NY 11102
Phone (718) 267-4245
1468 Madison Ave
New York, NY 10029
Phone (212) 241-0440
1440 Madison Ave
New York, NY 10029
Phone (212) 241-5561
1000 10th Ave
New York, NY 10019
Phone (212) 523-2369
638 Columbus Ave
New York, NY 10024
Phone (212) 523-8672
234 E 85th St
New York, NY 10028
Phone (212) 241-6585
1176 5th Ave
New York, NY 10029
Phone (212) 241-6237
150 E 42nd St
Fl 10
New York, NY 10017
Phone (646) 605-8119
Networks
- Healthfirst Medicare Network H1722
- Healthfirst Medicare Network H9678
- Healthfirst Medicare Network H5989
- Healthfirst Medicare Network H3359
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Emergency Medicine Physician | 207P00000X | 268067 | NY | Yes |
Addresses
Primary practice location
1825 Eastchester Road
Montefiore, Weiler Hospital
Bronx, NY 10461
Mailing address
1825 Eastchester Road
Montefiore, Weiler Hospital
Bronx, NY 10461-1138
Phone (718) 904-3333
Other providers in Bronx, NY
- Maheen Abbasi
- Noreen Abbasi
- Barbara Abbey-Mensah
- Leland Abbey
- Marjorie Abbey
- Ira R Abbott
- Kristen Rose Abbott
- Eliana Abboudi
- Abc Baby Talks Developmental Services, LLC
- Abc Dental PC
All providers in Bronx, NY · Emergency Medicine Physician in New York
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 8, 2014. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.