NPIMap

Individual provider Active NPI

Theodore Elias Allen, M.D.

  • Internal Medicine Physician
  • Bronx, NY
National Provider Identifier
1659379147
Registry record updated Jun 13, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
129095 Issued in NY
Practice address
2015 Grand Concourse
Bronx, NY 10453-4303
Phone
(718) 299-7295
Fax
(718) 299-6797
NPI assigned
Jul 8, 2005
Last updated
Jun 13, 2016By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 13, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 129095 NY Primary

Addresses

Primary practice location

2015 Grand Concourse
Bronx, NY 10453-4303

Mailing address

3198 Grand Concourse
Bronx, NY 10458-1000
Phone (718) 618-0401

Other identifiers 1

IdentifierTypeStateIssuer
00238188MedicaidNY

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20110419000689 NY Practitioner - Internal MedicinePractitioner - Hematology 9032394952 Reassigns benefits to 6 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal MedicineAlso: Hematology
Education
Other, 1972
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Bronx Medical Practice PCGroup PAC ID 9739496100, 136 clinicians
Calvary Hospital IncGroup PAC ID 9133010382, 50 clinicians
Fulton Medical PCGroup PAC ID 8527201540, 19 clinicians

Practice addresses (Care Compare)

14040 Sanford Ave
Flushing, NY 11355-2556
Phone (718) 299-7295

1740 Eastchester Rd
Bronx, NY 10461-2300
Phone (718) 518-2000

60 Queens St
Suite 100
Syosset, NY 11791-3058
Phone (631) 271-9151

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Calvary Hospital Inc CurrentSince Dec 1, 2019 Accepting new patients
Nassau Medical Home Visits P.C. Internal Medicine CurrentSince Jun 2, 2019 Accepting new patients
Essen Medical Associates, PC CurrentSince Jan 3, 2017 Accepting new patients
Calvary Hospital Inc CurrentSince Dec 1, 2019 Accepting new patients
Essen Medical Associates, PC CurrentSince Jan 3, 2017 Accepting new patients
Fulton Medical, P.C. Internal Medicine CurrentSince Jun 2, 2019 Accepting new patients
House Call Medical Services of New York, PLLC Internal Medicine CurrentSince Jan 3, 2017 Accepting new patients
Cold Spring Acquisition LLC Past Accepting new patients

Locations

1371 Seabury Ave
Bronx, NY 10461
Phone (718) 294-6200

1740 Eastchester Rd
Bronx, NY 10461
Phone (718) 518-2000

2015 Grand Concourse
Bronx, NY 10453
Phone (718) 294-6200

2015 Grand Concourse
#13202
Bronx, NY 10453

2505 Grand Ave
Bronx, NY 10468
Phone (718) 295-1400

8989 Union Tpke
Ste A
Glendale, NY 11385
Phone (718) 746-0400

60 Queens St
Ste 100
Syosset, NY 11791
Phone (347) 267-0904

Organizations & group practices 9

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 9

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": "1120780800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1465776000000",
    "number": "1659379147",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3198 GRAND CONCOURSE",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "104581000",
            "telephone_number": "718-618-0401",
            "fax_number": "718-795-4394"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2015 GRAND CONCOURSE",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "104534303",
            "telephone_number": "718-299-7295",
            "fax_number": "718-299-6797"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ALLEN",
        "first_name": "THEODORE",
        "middle_name": "ELIAS",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-07-08",
        "last_updated": "2016-06-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NY",
            "license": "129095",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00238188",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Bronx, NY

Sources for this page

Verify at the official NPI Registry.