NPIMap

Individual provider Active NPI

Angela Condo, MD

  • Geriatric Medicine (Internal Medicine) Physician
  • New York, NY
National Provider Identifier
1780079020
Registry record updated Aug 21, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Geriatric Medicine (Internal Medicine) PhysicianTaxonomy code 207RG0300X
License
06060035 Issued in NY
Practice address
1 Gustave L Levy PL FL 12
New York, NY 10029
Phone
(212) 241-6500
NPI assigned
Apr 3, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 21, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Geriatric Medicine (Internal Medicine) Physician 207RG0300X 06060035 NY Primary

Addresses

Primary practice location

1 Gustave L Levy PL FL 12
New York, NY 10029

Mailing address

91 W 5TH St
Bayonne, NJ 07002-1111
Phone (212) 463-0101

Other practice location 1

275 8th Ave
New York, NY 10011-1611
Phone (212) 420-2620

Other identifiers 1

IdentifierTypeStateIssuer
06060035MedicaidNY

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NJ, NY2 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20190306001183 NJ Practitioner - Internal MedicinePractitioner - Geriatric Medicine 4688928492 Reassigns benefits to 1 organization
I20200804002168 NY Practitioner - Internal MedicinePractitioner - Geriatric Medicine 4688928492 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal MedicineAlso: Geriatric Medicine
Education
Rutgers R W Johnson Medical School (Cam/New Bruns/Pisc), 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

10 Union SQ E
New York, NY 10003-3314
Phone (212) 844-8930

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
06060035NYMDGeriatric Medicine (Internal Medicine) Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Icahn School of Medicine at Mount Sinai Geriatric Medicine CurrentSince Jul 1, 2020 Accepting new patients
Dominick Condo, MD PA CurrentSince Jan 3, 2019 Accepting new patients
Icahn School of Medicine at Mount Sinai CurrentSince Jul 1, 2020 Accepting new patients
Icahn School of Medicine at Mount Sinai Past Accepting new patients
Dominick Condo MD PA PastSince Jan 3, 2019 Accepting new patients

Locations

622 Broadway
Bayonne, NJ 07002
Phone (201) 436-2800

10 Union Sq E
Ste 3G
New York, NY 10003
Phone (212) 844-8100

505 E 70th St
New York, NY 10021
Phone (212) 746-2900

1 Gustave L Levy Pl
Fl 12
New York, NY 10029
Phone (212) 241-1518

150 E 42nd St
Fl 10
New York, NY 10017
Phone (646) 605-8119

5 E 98th St
Fl 5
New York, NY 10029
Phone (212) 241-8234

10 Union Sq E
New York, NY 10003
Phone (212) 253-6800

275 8th Ave
New York, NY 10011
Phone (212) 420-2620

Networks

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

Organizations & group practices 5

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.

Hospital & facility affiliations 12

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1428019200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1597968000000",
    "number": "1780079020",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "91 W 5TH ST",
            "city": "BAYONNE",
            "state": "NJ",
            "postal_code": "070021111",
            "telephone_number": "212-463-0101"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 GUSTAVE L LEVY PL FL 12",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "10029",
            "telephone_number": "212-241-6500"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "275 8th Ave",
            "address_purpose": "LOCATION",
            "city": "New York",
            "state": "NY",
            "postal_code": "100111611",
            "country_code": "US",
            "telephone_number": "212-420-2620",
            "fax_number": "212-420-3804",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CONDO",
        "first_name": "ANGELA",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-04-03",
        "last_updated": "2020-08-21",
        "certification_date": "2020-08-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RG0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Geriatric Medicine",
            "state": "NY",
            "license": "06060035",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "06060035",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

Verify at the official NPI Registry.