Ilene Fennoy, MD

Primary specialty

Pediatric Endocrinology PhysicianTaxonomy code 2080P0205X

License

122361 Issued in NY

Practice address

3959 Broadway
CHN 106
New York, NY 10032

Phone

(212) 305-6559

Fax

(212) 305-4778

NPI assigned

Aug 16, 2005

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

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: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

Networks

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

Interoperability endpoints

• Direct secure messaging: ifennoy675411@nychhc.direct-ci.com
• FHIR API: https://epicproxy-pub.et1089.epichosted.com/FHIRProxy/api/FHIR/R4/
• FHIR API: https://epicproxy-pub.et1089.epichosted.com/FHIRProxy/api/FHIR/DSTU2/
• Direct secure messaging: ilf9001@direct.nyp.org

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.

• Harlem Medical Associates PC

  • General Practice Physician
  • New York, NY
  • NPI 1487957692
  Medicare reassignment NPD
• Physician Affiliate Group of New York PC

  • Registered Dietitian
  • New York, NY
  • NPI 1013375526
  Medicare reassignment NPD
• Trustees of Columbia University in the City of New York

  • Internal Medicine Physician
  • New York, NY
  • NPI 1437176047
  Medicare reassignment NPD
• Trustees of Columbia University in the City of New York

  • Surgery Physician
  • New York, NY
  • NPI 1508266347

  Pediatrics

  Medicare reassignment NPD
• Trustees of Columbia University in the City of New York

  • Internal Medicine Physician
  • New York, NY
  • NPI 1699289488
  NPD

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

{
    "created_epoch": "1124150400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1786752000000",
    "number": "1770575862",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "630 W 168TH ST",
            "address_2": "PH5E 522",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "10032",
            "telephone_number": "212-305-6559",
            "fax_number": "212-305-4778"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3959 BROADWAY",
            "address_2": "CHN 106",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "10032",
            "telephone_number": "212-305-6559",
            "fax_number": "212-305-4778"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "19 Bradhurst Ave Ste 2900S",
            "address_purpose": "LOCATION",
            "city": "Hawthorne",
            "state": "NY",
            "postal_code": "105322194",
            "country_code": "US",
            "telephone_number": "914-919-9280",
            "fax_number": "914-366-3407",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "FENNOY",
        "first_name": "ILENE",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-08-16",
        "last_updated": "2026-08-15",
        "certification_date": "2026-08-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2080P0205X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Endocrinology",
            "state": "NY",
            "license": "122361",
            "primary": true
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "NY",
            "license": "122361",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01126769",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Nicolas Anthony Fennelli, D.C.
• Jeffrey John Fennelly, LCSW
• Maxine Annie Fenner, MD
• Samuel Fenner, MD
• Aijia Fennick
• Gina Fenoaltea, MA, CCC-SLP
• Sofia Fenselau de Felippes
• Suzanne Silverman Fenske, M.D.
• Fenster Chiropractic, P.C
• Fenster Chiropractic,PC

• Pediatric Endocrinology Physician in New York, NY
• Providers in New York, NY by specialty
• Pediatric Endocrinology Physician in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 15, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.