NPIMap

Organization Active NPI

Saint Vincent Medical Center

Doing business as St. Vincent OB/GYN Faculty Practice

  • Obstetrics & Gynecology Physician
  • New York, NY
National Provider Identifier
1659309292
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X
Legal business name
SAINT VINCENT MEDICAL CENTER
Doing business as
St. Vincent OB/GYN Faculty Practice
Practice address
153 W 11TH St
New York, NY 10011-8305
Phone
(212) 604-2070
Fax
(212) 563-0605
NPI assigned
Jun 30, 2006
Last updated
Aug 22, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Dr. John P Koulos, M.D.
Title
Director
Phone
(212) 604-2070

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics & Gynecology Physician 207V00000X NU Primary

Addresses

Primary practice location

153 W 11TH St
New York, NY 10011-8305

Mailing address

29 West 34H Street
4TH Floor
New York, NY 10001
Phone (212) 563-2497

Other identifiers 1

IdentifierTypeStateIssuer
02494668MedicaidNY

Other names 1

  • St. Vincent OB/GYN Faculty Practice Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Saint Vincents Comprehensive Cancer Center8 organizations share this tax ID, including this one

Other organizations with this tax ID 7

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

NPI Registry JSON

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

{
    "created_epoch": "1151625600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1659309292",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "29 WEST 34H STREET",
            "address_2": "4TH FLOOR",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "10001",
            "telephone_number": "212-563-2497",
            "fax_number": "212-563-0605"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "153 W 11TH ST",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100118305",
            "telephone_number": "212-604-2070",
            "fax_number": "212-563-0605"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SAINT VINCENT MEDICAL CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-30",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "KOULOS",
        "authorized_official_first_name": "JOHN",
        "authorized_official_middle_name": "P",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "212-604-2070",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02494668",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "St. Vincent OB/GYN Faculty Practice",
            "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 Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.