Individual provider Active NPI

Marla Koroly, MD

  • Internal Medicine Physician
  • Mount Kisco, NY
National Provider Identifier
1780677336
Registry record updated Sep 24, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
170687 Issued in NY
Practice address
400 E Main St
Northern Westchester Hospital
Mount Kisco, NY 10549-3417
Phone
(914) 666-1200
Fax
(914) 666-1055
NPI assigned
Aug 30, 2005
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 24, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 170687 NY Primary

Addresses

Primary practice location

400 E Main St
Northern Westchester Hospital
Mount Kisco, NY 10549-3417

Mailing address

400 E Main St
Northern Westchester Hospital - Administration
Mount Kisco, NY 10549-3417
Phone (914) 666-1200

Other identifiers 1

IdentifierTypeStateIssuer
WEU121OtherMEDICARE GROUP PIN

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050331000675 NY Practitioner - HospitalistPractitioner - Internal Medicine 9931151073 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
170687NYMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Northern Westchester Hospital Association CurrentSince Oct 7, 2010 Accepting new patients
Northern Westchester Hospital Association Current Accepting new patients
Northern Westchester Hospital Association Internal Medicine CurrentSince Oct 7, 2010 Accepting new patients
Docs Physicians Affiliated With Bimc Internal Medicine Past Accepting new patients

Locations

400 E Main St
Mount Kisco, NY 10549
Phone (914) 666-1200

39 Smith Ave
Mount Kisco, NY 10549
Phone (914) 241-8200

Interoperability endpoints

  • Direct secure messaging: mkoroly66754@northwell.direct-ci.com
  • Direct secure messaging: marla.korolymd.p1@direct.westchesterhealth.nextgenshare.com

Organizations & group practices 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1125360000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1190592000000",
    "number": "1780677336",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "400 E MAIN ST",
            "address_2": "NORTHERN WESTCHESTER HOSPITAL - ADMINISTRATION",
            "city": "MOUNT KISCO",
            "state": "NY",
            "postal_code": "105493417",
            "telephone_number": "914-666-1200",
            "fax_number": "914-666-1055"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "400 E MAIN ST",
            "address_2": "NORTHERN WESTCHESTER HOSPITAL",
            "city": "MOUNT KISCO",
            "state": "NY",
            "postal_code": "105493417",
            "telephone_number": "914-666-1200",
            "fax_number": "914-666-1055"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOROLY",
        "first_name": "MARLA",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-08-30",
        "last_updated": "2007-09-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NY",
            "license": "170687",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE GROUP PIN",
            "identifier": "WEU121",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Mount Kisco, NY

Sources for this page

Verify at the official NPI Registry.