Individual provider Active NPI

Eddys Disla, M.D.

  • Rheumatology Physician
  • New York, NY
National Provider Identifier
1679619233
Registry record updated Apr 17, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Rheumatology PhysicianTaxonomy code 207RR0500X
License
182472 Issued in NY
Practice address
1St Ave & E 16TH St
7TH Floor
New York, NY 10003
Phone
(212) 420-3131
NPI assigned
Jan 30, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 17, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Rheumatology Physician 207RR0500X 182472 NY Primary

Addresses

Primary practice location

1St Ave & E 16TH St
7TH Floor
New York, NY 10003

Mailing address

PO Box 95000-2433
Philadelphia, PA 19195-0001
Phone (212) 420-3131

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: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20071002000703 NY Practitioner - Internal MedicinePractitioner - Rheumatology 6002901345 Reassigns benefits to 1 organization
Practice locations: New York, NY

Care Compare profile

Medicare Care Compare
Specialty
Internal MedicineAlso: Rheumatology
Education
Other, 1983
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Icahn School of Medicine at Mount SinaiGroup PAC ID 2264691070, 2,809 clinicians

Practice addresses (Care Compare)

1 St Ave and 16TH St
New York, NY 10003
Phone (212) 844-8101

Hospital & facility affiliations

  • Mount Sinai Beth Israel Hospital, New York, NY, CCN 330169

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
182472NYMDRheumatology Physician

Practice roles (4 of 8)

OrganizationSpecialtyStatusNew patients
Icahn School of Medicine at Mount Sinai CurrentSince Jan 1, 2016 Accepting new patients
Icahn School of Medicine at Mount Sinai Rheumatology CurrentSince Jan 1, 2016 Accepting new patients
Bimc Faculty Practice Past Accepting new patients
Icahn School of Medicine at Mount Sinai Past Accepting new patients

Locations

10 Union Sq E
New York, NY 10003
Phone (212) 253-6800

10 Union Sq E
#3
New York, NY 10003
Phone (212) 420-4145

10 Union Sq E
Frnt 5
New York, NY 10003
Phone (212) 253-6800

Networks

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

Organizations & group practices 4

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

Hospital & facility affiliations 3

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": "1170115200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1555459200000",
    "number": "1679619233",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 95000-2433",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191950001",
            "telephone_number": "212-420-3131"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1ST AVE & E 16TH ST",
            "address_2": "7TH FLOOR",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "10003",
            "telephone_number": "212-420-3131"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DISLA",
        "first_name": "EDDYS",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-01-30",
        "last_updated": "2019-04-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RR0500X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Rheumatology",
            "state": "NY",
            "license": "182472",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

Verify at the official NPI Registry.