Individual provider Active NPI

Elpidio Jimenez, MD

  • Anatomic Pathology & Clinical Pathology Physician
  • New York, NY
National Provider Identifier
1649279712
Registry record updated Dec 3, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anatomic Pathology & Clinical Pathology PhysicianTaxonomy code 207ZP0102X
License
181405 Issued in NY
Practice address
1St Ave & E 16TH Street
New York, NY 10003
Phone
(212) 420-2124
Fax
(212) 844-1945
NPI assigned
Jul 20, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 3, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Anatomic Pathology & Clinical Pathology Physician 207ZP0102X 181405 NY Primary

Addresses

Primary practice location

1St Ave & E 16TH Street
New York, NY 10003

Mailing address

1900 Hempstead Tpke
Suite 500
East Meadow, NY 11554-1724
Phone (516) 542-1090

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
I20070907000507 NY Practitioner - Pathology 4486747318 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Pathology
Education
Other, 1982
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Orange Pathology Associates, PCGroup PAC ID 5698664159, 13 clinicians

Practice addresses (Care Compare)

160 E Main St
Port Jervis, NY 12771-2253
Phone (201) 661-7280

1980 Crompond Rd
Cortlandt Manor, NY 10567-4144
Phone (201) 661-7280

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Premier Medical Group of the Hudson Valley, P.C. CurrentSince Feb 25, 2018 Accepting new patients
Premier Medical Group of the Hudson Valley P.C. CurrentSince Feb 25, 2018 Accepting new patients
Orange Pathology Associates, PC Anatomic Pathology & Clinical Pathology CurrentSince May 6, 2013 Accepting new patients
Beth Israel Medical Center Anatomic Pathology & Clinical Pathology Past Accepting new patients
Long Island College Hosp Anatomic Pathology & Clinical Pathology Past Accepting new patients
Long Island College Hospital PastSince Feb 1, 2007 Accepting new patients
State of New York Anatomic Pathology & Clinical Pathology Past Accepting new patients

Locations

535 E Crescent Ave
Ramsey, NJ 07446
Phone (201) 447-2020

160 E Main St
Port Jervis, NY 12771
Phone (845) 856-7000

243 North Rd
Ste 304
Poughkeepsie, NY 12601
Phone (845) 451-7251

Interoperability endpoints

  • Direct secure messaging: edj9020@direct.weillcornell.org
  • Direct secure messaging: ejimenez@premiermedicalhv.medentdirect.com

Organizations & group practices 7

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": "1121817600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1196640000000",
    "number": "1649279712",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1900 HEMPSTEAD TPKE",
            "address_2": "SUITE 500",
            "city": "EAST MEADOW",
            "state": "NY",
            "postal_code": "115541724",
            "telephone_number": "516-542-1090",
            "fax_number": "516-794-8165"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1ST AVE & E 16TH STREET",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "10003",
            "telephone_number": "212-420-2124",
            "fax_number": "212-844-1945"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JIMENEZ",
        "first_name": "ELPIDIO",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-07-20",
        "last_updated": "2007-12-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207ZP0102X",
            "taxonomy_group": "",
            "desc": "Pathology, Anatomic Pathology & Clinical Pathology",
            "state": "NY",
            "license": "181405",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

Verify at the official NPI Registry.