One Eleven Medical, PC

Primary specialty

Gastroenterology PhysicianTaxonomy code 207RG0100X

License

147236 Issued in NY

Legal business name

ONE ELEVEN MEDICAL, PC

Practice address

111 E 80TH St
Suite 1C
New York, NY 10075-0334

Phone

(212) 734-5533

Fax

(212) 717-1688

NPI assigned

Jan 14, 2016

Last updated

Jan 14, 2016By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Michael Krumholz, MDNPI 1700886645

Title

Owner

Phone

(212) 734-5533

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in NY

Enrollment records 1

Practitioners 1

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.

• Michael Peter Krumholz, M.D.

  • Gastroenterology Physician
  • New York, NY
  • NPI 1700886645
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1452729600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1452729600000",
    "number": "1770949117",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "111 E 80TH ST",
            "address_2": "SUITE 1C",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100750334",
            "telephone_number": "212-734-5533",
            "fax_number": "212-717-1688"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "111 E 80TH ST",
            "address_2": "SUITE 1C",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100750334",
            "telephone_number": "212-734-5533",
            "fax_number": "212-717-1688"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ONE ELEVEN MEDICAL, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-01-14",
        "last_updated": "2016-01-14",
        "status": "A",
        "authorized_official_last_name": "KRUMHOLZ",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "212-734-5533",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207RG0100X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "NY",
            "license": "147236",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Victoria Onbreyt, MD
• Oncology Consultants PC
• Oncology Medicine of Manhattan, PLLC
• Janae Kimiko Onda
• One Chiropractic Nyc, PLLC
• One Gustave L Levy Place Independent Practice Association LLC
• One Medical Group, P.C. (One Medica Group)
• One Medical Group, PC
• One Medical of Ny, P.C. (One Medical)
• One Medical of Ny, P.C. (One Medical)

• Gastroenterology Physician in New York, NY
• Providers in New York, NY by specialty
• Gastroenterology Physician in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 14, 2016; 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.