NPIMap

Organization Active NPI

Balm of Gilead Medical Office, PC

  • Internal Medicine Physician
  • Bronx, NY
National Provider Identifier
1720104474
Registry record updated Apr 22, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
Legal business name
BALM OF GILEAD MEDICAL OFFICE, PC
Practice address
4626 White Plains Rd
Bronx, NY 10470-1610
Phone
(718) 547-4077
NPI assigned
Mar 22, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 22, 2021

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

Authorized official

Name
Gregory Emili, M.DNPI 1932287042
Title
Associate Program Director
Phone
(718) 547-4077

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207R00000X 211144-1 NY
Internal Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207R00000X Primary
Interventional Pain Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 208VP0014X

Addresses

Primary practice location

4626 White Plains Rd
Bronx, NY 10470-1610

Mailing address

4626 White Plains Rd
Bronx, NY 10470-1610
Phone (718) 547-4077

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20031104000081 NY Part B Supplier - Clinic/Group Practice 5799697223 Receives reassigned benefits from 11 practitioners
Practice locations: Spring Valley, NY; Bronx, NY

National Provider Directory

National Provider Directory

Locations

95 N Main St
Spring Valley, NY 10977
Phone (845) 425-8800

Practitioners & affiliated clinicians

Practitioners 11

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

NPI Registry JSON

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

{
    "created_epoch": "1174521600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1619049600000",
    "number": "1720104474",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4626 WHITE PLAINS RD",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "104701610",
            "telephone_number": "718-547-4077"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4626 WHITE PLAINS RD",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "104701610",
            "telephone_number": "718-547-4077"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BALM OF GILEAD MEDICAL OFFICE, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-22",
        "last_updated": "2021-04-22",
        "certification_date": "2021-04-22",
        "status": "A",
        "authorized_official_last_name": "EMILI",
        "authorized_official_first_name": "GREGORY",
        "authorized_official_title_or_position": "ASSOCIATE PROGRAM DIRECTOR",
        "authorized_official_telephone_number": "718-547-4077",
        "authorized_official_credential": "M.D"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine",
            "state": "NY",
            "license": "211144-1",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "208VP0014X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Pain Medicine, Interventional Pain Medicine",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "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 Apr 22, 2021; 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.