NPIMap

Organization Active NPI

Icahn School of Medicine at Mount Sinai

  • Urology Physician
  • New York, NY
National Provider Identifier
1750647152
Registry record updated Jun 24, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Urology PhysicianTaxonomy code 208800000X
Legal business name
ICAHN SCHOOL OF MEDICINE AT MOUNT SINAI
Practice address
5 E 98TH St FL 6
Box 1272
New York, NY 10029-6501
Phone
(212) 241-4812
Fax
(212) 987-4675
NPI assigned
Apr 10, 2012
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 24, 2015

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

Authorized official

Name
Crystal Macneill
Title
Cbo Director, Vice President
Phone
(646) 605-8112

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Urology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 208800000X Primary

Addresses

Primary practice location

5 E 98TH St FL 6
Box 1272
New York, NY 10029-6501

Mailing address

PO Box 28082
New York, NY 10087-8082
Phone (212) 987-3100

Other names 1

  • UROLOGY DEPARTMENT OF MOUNT SINAI Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY, NJ2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20130920000028 NY Part B Supplier - Clinic/Group Practice 2264691070 Receives reassigned benefits from 115 practitioners
Practice locations: New York, NY; Long Island City, NY; Brooklyn, NY; Astoria, NY
O20131018001625 NJ Part B Supplier - Clinic/Group Practice 2264691070 Receives reassigned benefits from 19 practitioners
13 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Paramus, NJ; Teaneck, NJ; Ridgewood, NJ; Long Branch, NY; Englewood Cliffs, NJ; Englewood, NJ; Edgewater, NJ; Berkeley Heights, NJ…

Other NPIs on the same Medicare enrollment 13

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

View all 13

National Provider Directory

National Provider Directory

Locations

2510 30th Ave
#O
Long Island City, NY 11102

425 W 59th St
New York, NY 10019
Phone (212) 376-3180

Practitioners & affiliated clinicians

Practitioners 119

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

View all 119

NPI Registry JSON

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

{
    "created_epoch": "1334016000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1435104000000",
    "number": "1750647152",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 28082",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100878082",
            "telephone_number": "212-987-3100",
            "fax_number": "646-605-3029"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5 E 98TH ST FL 6",
            "address_2": "BOX 1272",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100296501",
            "telephone_number": "212-241-4812",
            "fax_number": "212-987-4675"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ICAHN SCHOOL OF MEDICINE AT MOUNT SINAI",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-04-10",
        "last_updated": "2015-06-24",
        "status": "A",
        "authorized_official_last_name": "MACNEILL",
        "authorized_official_first_name": "CRYSTAL",
        "authorized_official_title_or_position": "CBO DIRECTOR, VICE PRESIDENT",
        "authorized_official_telephone_number": "646-605-8112"
    },
    "taxonomies": [
        {
            "code": "208800000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Urology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "UROLOGY DEPARTMENT OF MOUNT SINAI",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in New York, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 24, 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.