NPIMap

Organization Active NPI

Weill Medical College of Cornell

Doing business as Cornell Internal Medicine Assoicates

  • Internal Medicine Physician
  • Long Island City, NY
National Provider Identifier
1649286139
Registry record updated Aug 6, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
Legal business name
WEILL MEDICAL COLLEGE OF CORNELL
Doing business as
Cornell Internal Medicine Assoicates
Practice address
3611 21St St
Long Island City, NY 11106-4705
Phone
(718) 482-7772
Fax
(718) 482-9648
NPI assigned
Aug 1, 2006
Last updated
Aug 6, 2015By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 6, 2015

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

Authorized official

Name
Ann F. Adenbaum
Title
Senior Director
Phone
(646) 962-5487

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X NU Primary

Addresses

Primary practice location

3611 21St St
Long Island City, NY 11106-4705

Mailing address

575 Lexington Ave
Suite 500
New York, NY 10022-6102
Phone (646) 962-5401

Other names 1

  • Cornell Internal Medicine Assoicates Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20031217000467 NY Part B Supplier - Clinic/Group Practice 6800709023 Receives reassigned benefits from 39 practitioners
2 other NPIs on this enrollment
Practice locations: Rego Park, NY; Long Island City, NY; Brooklyn, NY; Forest Hills, NY; Flushing, NY; Astoria, NY

Other NPIs on the same Medicare enrollment 2

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory
Tax ID family
Anne Moore90 organizations share this tax ID, including this one

Organizations with this tax ID in the same state 24

This tax ID family is large, so up to 24 of its organizations in the same state are linked here.

View all 24

Practitioners & affiliated clinicians

Practitioners 41

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 41

NPI Registry JSON

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

{
    "created_epoch": "1154390400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1438819200000",
    "number": "1649286139",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "575 LEXINGTON AVE",
            "address_2": "SUITE 500",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100226102",
            "telephone_number": "646-962-5401",
            "fax_number": "646-962-0293"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3611 21ST ST",
            "city": "LONG ISLAND CITY",
            "state": "NY",
            "postal_code": "111064705",
            "telephone_number": "718-482-7772",
            "fax_number": "718-482-9648"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WEILL MEDICAL COLLEGE OF CORNELL",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-01",
        "last_updated": "2015-08-06",
        "status": "A",
        "authorized_official_last_name": "ADENBAUM",
        "authorized_official_first_name": "ANN",
        "authorized_official_middle_name": "F.",
        "authorized_official_title_or_position": "SENIOR DIRECTOR",
        "authorized_official_telephone_number": "646-962-5487"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Cornell Internal Medicine Assoicates",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Long Island City, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 6, 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.