NPIMap

Organization Active NPI

Icahn School of Medicine at Mount Sinai

Doing business as Radiation Oncology Department of Mount Sinai

  • Radiation Oncology Physician
  • New York, NY
National Provider Identifier
1770856254
Registry record updated Jul 30, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Radiation Oncology PhysicianTaxonomy code 2085R0001X
Legal business name
ICAHN SCHOOL OF MEDICINE AT MOUNT SINAI
Doing business as
Radiation Oncology Department of Mount Sinai
Practice address
1184 5TH Ave # 1236
New York, NY 10029-6503
Phone
(212) 241-0025
Fax
(212) 987-2468
NPI assigned
Feb 15, 2012
Last updated
Jul 30, 2015By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 30, 2015

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

Authorized official

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Radiation Oncology Physician 2085R0001X NU Primary

Addresses

Primary practice location

1184 5TH Ave # 1236
New York, NY 10029-6503

Mailing address

P.O. Box 28082
New York, NY 10087-8082
Phone (212) 987-3100

Other names 1

  • RADIATION ONCOLOGY DEPARTMENT OF MOUNT SINAI Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20120723000107 NY Part B Supplier - Clinic/Group Practice 2264691070 Receives reassigned benefits from 34 practitioners
Practice locations: Astoria, NY; New York, NY; Staten Island, NY

National Provider Directory

National Provider Directory

Locations

1184 5th Ave
#1236
New York, NY 10029
Phone (212) 241-7500

Practitioners & affiliated clinicians

Practitioners 34

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 34

NPI Registry JSON

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

{
    "created_epoch": "1329264000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1438214400000",
    "number": "1770856254",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "P.O. 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": "1184 5TH AVE # 1236",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100296503",
            "telephone_number": "212-241-0025",
            "fax_number": "212-987-2468"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ICAHN SCHOOL OF MEDICINE AT MOUNT SINAI",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-02-15",
        "last_updated": "2015-07-30",
        "status": "A",
        "authorized_official_last_name": "MACNEILL",
        "authorized_official_first_name": "CRYSTAL",
        "authorized_official_title_or_position": "VICE PRESIDENT, CBO DIRECTOR",
        "authorized_official_telephone_number": "646-605-8112"
    },
    "taxonomies": [
        {
            "code": "2085R0001X",
            "taxonomy_group": "",
            "desc": "Radiology, Radiation Oncology",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "RADIATION ONCOLOGY 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 Jul 30, 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.