NPIMap

New York University

Organization Active NPI Internal Medicine Physician · Harrison, NY

NPI 1679397491 · NPPES record last updated Nov 12, 2024

Key facts

NPI
1679397491
Entity type
Organization (NPI type 2)
Primary specialty
Internal Medicine Physician 207R00000X
Legal business name
NEW YORK UNIVERSITY
Practice address
450 Mamaroneck Ave Ste 200
Harrison, NY 10528-2430
Phone
(914) 556-4960
Fax
(914) 265-9164
NPI assigned
Nov 8, 2024
Organization subpart
No

Authorized official

Name
Andrew Rubin
Title
Sr, VP Clinical Affairs & Amb Care
Phone
(212) 263-2672

Corporate family (same tax ID) 24

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

Laboratory certificates & supplier records

Name & address match These CMS records do not include an NPI. They are shown here because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
33D2315334NYU Langone Medical Associates - Harrison
450 Mamaroneck Ave - Suite 200, Harrison, NY 10528		Certificate of waiverMar 26, 2027

Medicare participation

Medicare fee-for-service enrollment
Enrolled in NY

All facility ownership & control disclosures 4

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
NYU Langone Hospitals
New York, NY · CCN 330214		 Hospital Operational/Managerial Control Apr 1, 2015
NYU Langone Hospitals Psychiatric Unit
New York, NY · CCN 33S214		 Hospital Operational/Managerial Control Apr 1, 2015
NYU Langone Hospitals
Mineola, NY · CCN 33021401		 Hospital Operational/Managerial Control Aug 1, 2019
NYU Langone Amb Care Commack
Garden City, NY · CCN 337187		 Home health agency Operational/Managerial Control Apr 1, 2015

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
O20250203001240 NY DME Supplier - Physician - General Practice 1355232422 Practice locations: Harrison, NY

National Provider Directory

Tax ID family
NYU Anesthesia Assoc (104 organizations share this tax ID)

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician
Group: 193200000X MULTI-SPECIALTY GROUP		 207R00000X Yes
Orthopaedic Surgery Physician
Group: 193200000X MULTI-SPECIALTY GROUP		 207X00000X
Physical Medicine & Rehabilitation Physician
Group: 193200000X MULTI-SPECIALTY GROUP		 208100000X
Podiatrist
Group: 193200000X MULTI-SPECIALTY GROUP		 213E00000X
Physical Therapist
Group: 193200000X MULTI-SPECIALTY GROUP		 225100000X

Addresses

Primary practice location

450 Mamaroneck Ave Ste 200
Harrison, NY 10528-2430

Mailing address

450 Mamaroneck Ave Ste 200
Harrison, NY 10528-2430
Phone (914) 556-4960

Other names

  • NYU Langone Medical Associates Harrison Doing business as

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on Nov 12, 2024.

{
    "created_epoch": "1731024000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1731369600000",
    "number": "1679397491",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "450 MAMARONECK AVE STE 200",
            "city": "HARRISON",
            "state": "NY",
            "postal_code": "105282430",
            "telephone_number": "914-556-4960",
            "fax_number": "914-265-9164"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "450 MAMARONECK AVE STE 200",
            "city": "HARRISON",
            "state": "NY",
            "postal_code": "105282430",
            "telephone_number": "914-556-4960",
            "fax_number": "914-265-9164"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NEW YORK UNIVERSITY",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-11-08",
        "last_updated": "2024-11-12",
        "certification_date": "2024-11-12",
        "status": "A",
        "authorized_official_last_name": "RUBIN",
        "authorized_official_first_name": "ANDREW",
        "authorized_official_title_or_position": "SR, VP CLINICAL AFFAIRS & AMB CARE",
        "authorized_official_telephone_number": "212-263-2672"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "207X00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Orthopaedic Surgery",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "208100000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physical Medicine & Rehabilitation",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "213E00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Podiatrist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "NYU Langone Medical Associates Harrison",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Harrison, NY

All providers in Harrison, NY · Internal Medicine Physician in New York

Sources for this page

Verify at the official NPI Registry.