Individual provider Active NPI

Celine Pourmoradi

  • Physician Assistant
  • New York, NY
National Provider Identifier
1750900239
Registry record updated Jul 7, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
025264 Issued in NY
Practice address
570 Lexington Ave FL 9
New York, NY 10022-6710
Phone
(646) 962-7277
NPI assigned
Apr 14, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 7, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 025264 NY Primary

Addresses

Primary practice location

570 Lexington Ave FL 9
New York, NY 10022-6710

Mailing address

570 Lexington Ave FL 9
New York, NY 10022-6710
Phone (646) 962-7277

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20220722001656 NY Practitioner - Physician Assistant 8921489840 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

1427 Madison Ave
New York, NY 10029-6514
Phone (212) 731-3609

5 E 98TH St 2ND FL
OB/GYN Dept of Mount Sinai
New York, NY 10029-6501
Phone (212) 241-2232

5 E 98TH St-14TH FLR
OB/GYN Department
New York, NY 10029-6501
Phone (212) 241-2232

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
025264NYMDOccupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Icahn School of Medicine at Mount Sinai CurrentSince Jul 1, 2022 Accepting new patients
Icahn School of Medicine at Mount Sinai CurrentSince Jul 1, 2022 Accepting new patients

Locations

150 E 42nd St
Fl 2
New York, NY 10017
Phone (646) 605-8119

1427 Madison Ave
New York, NY 10029

5 E 98th St
Fl 2
New York, NY 10029
Phone (212) 241-6551

Networks

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

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1586822400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1688688000000",
    "number": "1750900239",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "570 LEXINGTON AVE FL 9",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100226710",
            "telephone_number": "646-962-7277"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "570 LEXINGTON AVE FL 9",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100226710",
            "telephone_number": "646-962-7277"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "POURMORADI",
        "first_name": "CELINE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-04-14",
        "last_updated": "2023-07-07",
        "certification_date": "2023-07-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NY",
            "license": "025264",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

Verify at the official NPI Registry.