Active NPI
Michele M Collins, DDS
- Dentist
- Bronx, NY
National Provider Identifier
1679199210
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 062249
- Practice address
- 1775 Grand Concourse
Bronx, NY 10453-8202 - Phone
- (718) 992-7669
- NPI assigned
- Jun 19, 2020
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Student in an Organized Health Care Education/Training Program | 390200000X | |||
| Dentist | 122300000X | 062249 | NY | Primary |
Addresses
Primary practice location
1775 Grand Concourse
Bronx, NY 10453-8202
Mailing address
25 W 132ND St Apt 5a
New York, NY 10037-3220
Phone (504) 975-1019
Other practice location 1
1005 Dr D B Todd Jr
3rd floor GPR clinic
nashville, TN 37208
Phone (504) 975-1019
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: No
- Hospice: Yes
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20240816002904 | NY | Order and Referring Only - Dentist | 4082152327 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1592524800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1715212800000",
"number": "1679199210",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "25 W 132ND ST APT 5A",
"city": "NEW YORK",
"state": "NY",
"postal_code": "100373220",
"telephone_number": "504-975-1019"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1775 GRAND CONCOURSE",
"city": "BRONX",
"state": "NY",
"postal_code": "104538202",
"telephone_number": "718-992-7669"
}
],
"practiceLocations": [
{
"address_1": "1005 Dr D B Todd Jr",
"address_2": "3rd floor GPR clinic",
"address_purpose": "LOCATION",
"city": "nashville",
"state": "TN",
"postal_code": "37208",
"country_code": "US",
"telephone_number": "504-975-1019",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "COLLINS",
"first_name": "MICHELE",
"middle_name": "M",
"credential": "DDS",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2020-06-19",
"last_updated": "2024-05-09",
"certification_date": "2024-05-09",
"status": "A"
},
"taxonomies": [
{
"code": "390200000X",
"taxonomy_group": "",
"desc": "Student in an Organized Health Care Education/Training Program",
"state": null,
"license": null,
"primary": false
},
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "NY",
"license": "062249",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Bronx, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 9, 2024; 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.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.