Mary Rose Puthiyamadam, MD

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

230358-1 Issued in NY

Practice address

80 Beekman Ave
Open Door Family Medical Centers, Inc.
Sleepy Hollow, NY 10591-2503

Phone

(914) 941-1263

Fax

(914) 941-0993

NPI assigned

Dec 15, 2006

Last updated

Dec 7, 2011By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

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

Specialty

Internal MedicineAlso: Pediatric Medicine

Education

State University of New York at Buffalo School of Medicine, 1999

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Open Door Family Medical Center IncGroup PAC ID 7113835380, 61 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Americare Certified Special Services, Inc Chha Home health agency, Brooklyn, NY, CCN 337290
• Phelps Hospital Hospital, Sleepy Hollow, NY, CCN 330261

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Networks

• Healthfirst Medicare Network H5989
• Healthfirst Medicare Network H1722
• Healthfirst Medicare Network H9678
• Healthfirst Medicare Network H3359

Interoperability endpoints

• FHIR API: https://fhir4.healow.com/fhir/r4/EAJCAA
• Direct secure messaging: maryrose.puthiyamadam@odfmc.eclinicaldirectplus.com

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.

• Open Door Family Medical Center Inc

  • Federally Qualified Health Center (FQHC)
  • Port Chester, NY
  • NPI 1285893719
  Medicare reassignment Care Compare group NPD
• Open Door Family Medical Center, Inc.

  • Federally Qualified Health Center (FQHC)
  • Mount Kisco, NY
  • NPI 1629237151
  NPD
• Open Door Family Medical Center, Inc.

  • Federally Qualified Health Center (FQHC)
  • Ossining, NY
  • NPI 1467487637
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Americare Certified Special Services, Inc.

  • Home Health Agency
  • Brooklyn, NY
  • NPI 1770513145
  Care Compare affiliation
• Phelps Memorial Hospital Association

  dba Phelps Hospital

  • General Acute Care Hospital
  • Sleepy Hollow, NY
  • NPI 1720185267
  Care Compare affiliation

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

{
    "created_epoch": "1166140800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1323216000000",
    "number": "1669534574",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "165 MAIN ST",
            "address_2": "OPEN DOOR FAMILY MEDICAL CENTERS, INC.",
            "city": "OSSINING",
            "state": "NY",
            "postal_code": "105624702",
            "telephone_number": "914-941-1263",
            "fax_number": "914-941-0993"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "80 BEEKMAN AVE",
            "address_2": "OPEN DOOR FAMILY MEDICAL CENTERS, INC.",
            "city": "SLEEPY HOLLOW",
            "state": "NY",
            "postal_code": "105912503",
            "telephone_number": "914-941-1263",
            "fax_number": "914-941-0993"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PUTHIYAMADAM",
        "first_name": "MARY ROSE",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-12-15",
        "last_updated": "2011-12-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NY",
            "license": "230358-1",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02479481",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Laura A. Pontrelli, PHD
• Margaret Mary Posca, LPN
• Martin Preciado, MD
• Alyssa Prete
• Public Schools of the Tarrytowns
• Linda Qian
• Quho Choi DDS PLLC
• Daniel Quillen
• Lauren Rabadi, DDS
• Layal Rabadi

• Internal Medicine Physician in Sleepy Hollow, NY
• Providers in Sleepy Hollow, NY by specialty
• Internal Medicine Physician in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 7, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.