Individual provider Active NPI

Tsontcho Alexandrov Ianchulev, M.D. MPH

  • Internal Medicine Physician
  • New York, NY
National Provider Identifier
1629046131
Registry record updated Mar 1, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
2817821 Issued in NY
Practice address
310 E 14TH St Ste 319
New York, NY 10003-4284
Phone
(617) 216-4369
Fax
(332) 237-5156
NPI assigned
Mar 9, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 1, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Ophthalmology Physician 207W00000X 2817821 NY
Internal Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207R00000X 2817821 NY Primary

Addresses

Primary practice location

310 E 14TH St Ste 319
New York, NY 10003-4284

Mailing address

310 E 14TH St Ste 319
New York, NY 10003-4284
Phone (617) 216-4369

Other practice location 1

151 E Post Rd Ste 111
White Plains, NY 10601-5209
Phone (617) 216-4369

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
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 1

Enrollment IDStateProvider typePAC IDDetails
I20170327000970 NY Practitioner - Ophthalmology 2163411505 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Ophthalmology
Education
Harvard Medical School, 1999
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

310 E 14TH St
Opthalmology Department of Mount Sinai
New York, NY 10003-4201
Phone (212) 241-0939

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
2817821NYMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Icahn School of Medicine at Mount Sinai Multi-Specialty CurrentSince Nov 1, 2021 Accepting new patients
Icahn School of Medicine at Mount Sinai Ophthalmology CurrentSince Nov 1, 2021 Accepting new patients
Gary L. Aguilar, M.D. Inc. Multi-Specialty CurrentSince Jun 30, 2012 Accepting new patients
Icahn School of Medicine at Mount Sinai Multi-Specialty Past Accepting new patients

Locations

711 Van Ness Ave
Ste 310
San Francisco, CA 94102
Phone (415) 421-8667

909 Hyde St
Ste 530
San Francisco, CA 94109
Phone (415) 775-3392

150 E 42nd St
Fl 10
New York, NY 10017
Phone (646) 605-8119

310 E 14th St
Ste 319
New York, NY 10003
Phone (212) 979-4500

310 E 14th St
New York, NY 10003
Phone (212) 979-4000

Organizations & group practices 4

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 1

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": "1141862400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1709251200000",
    "number": "1629046131",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "310 E 14TH ST STE 319",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100034284",
            "telephone_number": "617-216-4369",
            "fax_number": "332-237-5156"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "310 E 14TH ST STE 319",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100034284",
            "telephone_number": "617-216-4369",
            "fax_number": "332-237-5156"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "151 E Post Rd Ste 111",
            "address_purpose": "LOCATION",
            "city": "White Plains",
            "state": "NY",
            "postal_code": "106015209",
            "country_code": "US",
            "telephone_number": "617-216-4369",
            "fax_number": "323-237-5156",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "IANCHULEV",
        "first_name": "TSONTCHO",
        "middle_name": "ALEXANDROV",
        "name_prefix": "Dr.",
        "credential": "M.D. MPH",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-03-09",
        "last_updated": "2024-03-01",
        "certification_date": "2024-03-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "NY",
            "license": "2817821",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine",
            "state": "NY",
            "license": "2817821",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

Verify at the official NPI Registry.