NPIMap

Individual provider Active NPI

Malcolm Johnson, M.D.

  • Emergency Medicine Physician
  • Astoria, NY
National Provider Identifier
1699111005
Registry record updated Aug 15, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
288266 Issued in NY
Practice address
Mount Sinai Medical Center
25-10 30TH Ave
Astoria, NY 11102
Phone
(718) 932-1000
NPI assigned
May 13, 2013
Last updated
Aug 15, 2025By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 15, 2025

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X 55804 CT
Student in an Organized Health Care Education/Training Program 390200000X CT
Emergency Medicine Physician 207P00000X 288266 NY Primary

Addresses

Primary practice location

Mount Sinai Medical Center
25-10 30TH Ave
Astoria, NY 11102

Mailing address

Mt Sinai Hosptial
25-10 30TH Ave
Astoria, NY 11102
Phone (718) 932-1000

Other practice location 1

20 York St # T-209
Yale-New Haven Hospital
New Haven, CT 06510-3220
Phone (203) 785-5174

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY, VA2 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20170531000589 NY Practitioner - Emergency Medicine 5597085704 Reassigns benefits to 5 organizations
I20170907000575 VA Practitioner - Emergency Medicine 5597085704 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Emergency Medicine
Education
Other, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Lake Spring Emergency Group LLCGroup PAC ID 6406103498, 51 clinicians
Exigence Medical of Binghamton PLLCGroup PAC ID 7012913916, 20 clinicians

Practice addresses (Care Compare)

1423 W Ruritan Rd
Roanoke, VA 24012-6715
Phone (540) 945-9900

1468 Madison Ave
New York, NY 10029-6508
Phone (212) 987-3100

169 Riveride Dr
Binghamton, NY 13905-4246
Phone (607) 798-5111

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
55804CTMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Icahn School of Medicine at Mount Sinai CurrentSince Feb 1, 2022 Accepting new patients
Kingsford Physician Services, LLC CurrentSince Jul 20, 2024 Accepting new patients
Icahn School of Medicine at Mount Sinai Emergency Medicine CurrentSince Feb 1, 2022 Accepting new patients
Icahn School of Medicine at Mount Sinai Current Accepting new patients
Fpa Hospital Based CurrentSince Jan 1, 2020 Accepting new patients
Lake Spring Emergency Group, LLC Emergency Medicine CurrentSince Dec 1, 2024 Accepting new patients
Fpa Hospital Based Emergency Medicine CurrentSince Jan 1, 2020 Accepting new patients
Emergency Physician Services of New York, P.C. Emergency Medicine CurrentSince Feb 14, 2026 Accepting new patients
Icahn School of Medicine at Mount Sinai Emergency Medicine CurrentSince Jun 1, 2021 Accepting new patients
Exigence Medical of Binghamton PLLC CurrentSince Mar 15, 2026 Accepting new patients
Kingsford Emergency Group, LLC Emergency Medicine CurrentSince Jun 5, 2024 Accepting new patients
Fpa Hospital Based Current Accepting new patients
North Carolina Em I Medical Services P C Past Accepting new patients

Locations

169 Riverside Dr
Binghamton, NY 13905
Phone (607) 798-5111

396 Broadway
Kingston, NY 12401
Phone (845) 331-3131

2510 30th Ave
Long Island City, NY 11102
Phone (718) 267-4245

1176 5th Ave
New York, NY 10029
Phone (212) 241-6237

1000 10th Ave
New York, NY 10019
Phone (212) 523-2369

1468 Madison Ave
New York, NY 10029
Phone (212) 241-0440

150 E 42nd St
Fl 10
New York, NY 10017
Phone (646) 605-8119

5 E 98th St
New York, NY 10029
Phone (212) 241-3986

638 Columbus Ave
New York, NY 10024
Phone (212) 523-8672

241 North Rd
Poughkeepsie, NY 12601
Phone (845) 431-8889

2209 Genesee St
Utica, NY 13501
Phone (315) 798-8100

111 Hospital Dr
Utica, NY 13502
Phone (315) 801-8534

2400 Lee Hwy N
Pulaski, VA 24301
Phone (540) 994-8100

1423 W Ruritan Rd
Roanoke, VA 24012
Phone (540) 945-9900

2706 Ogden Rd
Roanoke, VA 24018
Phone (540) 970-8000

1900 Electric Rd
Salem, VA 24153
Phone (540) 772-3400

Networks

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

Organizations & group practices 13

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.

View all 13

Hospital & facility affiliations 8

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": "1368403200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1755216000000",
    "number": "1699111005",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "MT SINAI HOSPTIAL",
            "address_2": "25-10 30TH AVE",
            "city": "ASTORIA",
            "state": "NY",
            "postal_code": "11102",
            "telephone_number": "718-932-1000",
            "fax_number": "203-785-4580"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "MOUNT SINAI MEDICAL CENTER",
            "address_2": "25-10 30TH AVE",
            "city": "ASTORIA",
            "state": "NY",
            "postal_code": "11102",
            "telephone_number": "718-932-1000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "20 York St # T-209",
            "address_2": "Yale-New Haven Hospital",
            "address_purpose": "LOCATION",
            "city": "New Haven",
            "state": "CT",
            "postal_code": "065103220",
            "country_code": "US",
            "telephone_number": "203-785-5174",
            "fax_number": "203-785-4580",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "MALCOLM",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2013-05-13",
        "last_updated": "2025-08-15",
        "certification_date": "2025-08-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "CT",
            "license": "55804",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "CT",
            "license": null,
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "NY",
            "license": "288266",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Astoria, NY

Sources for this page

Verify at the official NPI Registry.