Individual provider Active NPI

Alvaro Jose Coronado Munoz, M.D.

  • Pediatric Critical Care Medicine Physician
  • Bronx, NY
National Provider Identifier
1710261037
Registry record updated Sep 25, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Critical Care Medicine PhysicianTaxonomy code 2080P0203X
License
325676-01 Issued in NY
Practice address
111 E 210TH St
Bronx, NY 10467-2401
Phone
(187) 412-4877
NPI assigned
Oct 5, 2011
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 25, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Critical Care Medicine Physician 2080P0203X R3655 TX
Pediatric Critical Care Medicine Physician 2080P0203X 325676-01 NY Primary

Addresses

Primary practice location

111 E 210TH St
Bronx, NY 10467-2401

Mailing address

46 Beechwood Rd
Hartsdale, NY 10530-1662
Phone (347) 586-2872

Other practice location 1

6411 Fannin St
Houston, TX 77030-1501
Phone (347) 586-2872

Other identifiers 1

IdentifierTypeStateIssuer
373821301MedicaidTX

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX, NY2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20170825000650 TX Practitioner - Pediatric MedicinePractitioner - Critical Care (Intensivists) 9739451782 Reassigns benefits to 1 organization
I20231114000433 NY Practitioner - Pediatric MedicinePractitioner - Gastroenterology 9739451782 Reassigns benefits to 2 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
325676-01NYMDPediatric Critical Care Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Ut Physicians CurrentSince Jul 16, 2017 Accepting new patients
Nuvance Health Medical Practice PC CurrentSince Apr 21, 2024 Accepting new patients
Ut Physicians CurrentSince Jul 16, 2017 Accepting new patients
Montefiore Medical Center CurrentSince Oct 13, 2023 Accepting new patients
Montefiore Medical Center CurrentSince Oct 13, 2023 Accepting new patients
Montefiore Medical Center Past Accepting new patients
Vassar Brothers Hospital Past Accepting new patients

Locations

111 E 210th St
Bronx, NY 10467

45 Reade Pl
Fl 2
Poughkeepsie, NY 12601
Phone (845) 483-6001

45 Reade Pl
Poughkeepsie, NY 12601
Phone (845) 331-3131

1515 Holcombe Blvd
#M
Houston, TX 77030
Phone (713) 792-6127

6411 Fannin St
Houston, TX 77030
Phone (713) 500-6200

6410 Fannin St
Ste 500
Houston, TX 77030
Phone (713) 500-5714

1515 Holcombe Blvd
Houston, TX 77030
Phone (713) 794-5446

Networks

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

Interoperability endpoints

  • Direct secure messaging: acoronadom@montefioredirect.com

Organizations & group practices 7

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.

NPI Registry JSON

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

{
    "created_epoch": "1317772800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1695600000000",
    "number": "1710261037",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "46 BEECHWOOD RD",
            "city": "HARTSDALE",
            "state": "NY",
            "postal_code": "105301662",
            "telephone_number": "347-586-2872"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "111 E 210TH ST",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "104672401",
            "telephone_number": "187-412-4877"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "6411 Fannin St",
            "address_purpose": "LOCATION",
            "city": "Houston",
            "state": "TX",
            "postal_code": "770301501",
            "country_code": "US",
            "telephone_number": "347-586-2872",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CORONADO MUNOZ",
        "first_name": "ALVARO",
        "middle_name": "JOSE",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-10-05",
        "last_updated": "2023-09-25",
        "certification_date": "2023-09-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2080P0203X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Critical Care Medicine",
            "state": "TX",
            "license": "R3655",
            "primary": false
        },
        {
            "code": "2080P0203X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Critical Care Medicine",
            "state": "NY",
            "license": "325676-01",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "373821301",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Bronx, NY

Sources for this page

Verify at the official NPI Registry.