NPIMap

Organization Active NPI

Downtown Bronx Medical Associates PC

  • Emergency Medical Services (Emergency Medicine) Physician
  • Bronx, NY
National Provider Identifier
1689618407
Registry record updated Jun 23, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medical Services (Emergency Medicine) PhysicianTaxonomy code 207PE0004X
Legal business name
DOWNTOWN BRONX MEDICAL ASSOCIATES PC
Practice address
234 E 149TH St
Ste 8D200
Bronx, NY 10451-5504
Phone
(718) 576-6200
Fax
(718) 579-6060
NPI assigned
Jun 15, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 23, 2015

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

Authorized official

Name
Mr. Peter I Gordon
Title
Executive Administrator
Phone
(718) 579-6200

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medical Services (Emergency Medicine) PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207PE0004X Primary

Addresses

Primary practice location

234 E 149TH St
Ste 8D200
Bronx, NY 10451-5504

Mailing address

234 E 149TH St
Ste 8D200
Bronx, NY 10451-5504
Phone (718) 576-6200

Other identifiers 1

IdentifierTypeStateIssuer
02084820MedicaidNY

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20031106000016 NY Part B Supplier - Clinic/Group Practice 9638082746 Receives reassigned benefits from 1,094 practitioners
Practice locations: Bronx, NY

National Provider Directory

National Provider Directory

Locations

234 E 149th St
Ste 8D200
Bronx, NY 10451
Phone (718) 576-6200

Practitioners & affiliated clinicians

Practitioners 1,249

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

View all 1,249

NPI Registry JSON

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

{
    "created_epoch": "1150329600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1435017600000",
    "number": "1689618407",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "234 E 149TH ST",
            "address_2": "STE 8D200",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "104515504",
            "telephone_number": "718-576-6200",
            "fax_number": "718-579-6060"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "234 E 149TH ST",
            "address_2": "STE 8D200",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "104515504",
            "telephone_number": "718-576-6200",
            "fax_number": "718-579-6060"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DOWNTOWN BRONX MEDICAL ASSOCIATES PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-15",
        "last_updated": "2015-06-23",
        "status": "A",
        "authorized_official_last_name": "GORDON",
        "authorized_official_first_name": "PETER",
        "authorized_official_middle_name": "I",
        "authorized_official_title_or_position": "EXECUTIVE ADMINISTRATOR",
        "authorized_official_telephone_number": "718-579-6200",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "207PE0004X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Emergency Medicine, Emergency Medical Services",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02084820",
            "state": "NY"
        }
    ],
    "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 Jun 23, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.