NPIMap

Organization Active NPI

Icahn School of Medicine at Mount Sinai

Doing business as Clinical Immunology Division of Mount Sinai

  • Allergy & Immunology Physician
  • New York, NY
National Provider Identifier
1639430671
Registry record updated Jun 24, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Allergy & Immunology PhysicianTaxonomy code 207K00000X
Legal business name
ICAHN SCHOOL OF MEDICINE AT MOUNT SINAI
Doing business as
Clinical Immunology Division of Mount Sinai
Practice address
1 Gustave L Levy PL
New York, NY 10029-6574
Phone
(212) 987-3100
Fax
(212) 731-5220
NPI assigned
Jun 6, 2012
Last updated
Jun 24, 2015By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 24, 2015

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

Authorized official

Name
Crystal Macneill
Title
Vice President, Cbo Director
Phone
(646) 605-8112

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Allergy & Immunology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207K00000X Primary

Addresses

Primary practice location

1 Gustave L Levy PL
New York, NY 10029-6574

Mailing address

PO Box 28082
New York, NY 10087-8082
Phone (212) 987-3100

Other names 1

  • Clinical Immunology Division of Mount Sinai Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20130102000264 NY Part B Supplier - Clinic/Group Practice 2264691070 Receives reassigned benefits from 18 practitioners
Practice locations: New York, NY; Rego Park, NY

National Provider Directory

National Provider Directory
Tax ID family
Faculty Practice Associates33 organizations share this tax ID, including this one

Other organizations with this tax ID 32

Organizations that report the same tax identification number in the National Provider Directory.

View all 32

Locations

10 Union Sq E
Frnt 3F
New York, NY 10003

Practitioners & affiliated clinicians

Practitioners 18

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 18

NPI Registry JSON

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

{
    "created_epoch": "1338940800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1435104000000",
    "number": "1639430671",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 28082",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100878082",
            "telephone_number": "212-987-3100",
            "fax_number": "212-731-5220"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 GUSTAVE L LEVY PL",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100296574",
            "telephone_number": "212-987-3100",
            "fax_number": "212-731-5220"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ICAHN SCHOOL OF MEDICINE AT MOUNT SINAI",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-06-06",
        "last_updated": "2015-06-24",
        "status": "A",
        "authorized_official_last_name": "MACNEILL",
        "authorized_official_first_name": "CRYSTAL",
        "authorized_official_title_or_position": "VICE PRESIDENT, CBO DIRECTOR",
        "authorized_official_telephone_number": "646-605-8112"
    },
    "taxonomies": [
        {
            "code": "207K00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Allergy & Immunology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Clinical Immunology Division of Mount Sinai",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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 Jun 24, 2015; 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.