NPIMap

Organization Active NPI

Weill Medical College of Cornell

  • Pediatric Critical Care Medicine Physician
  • New York, NY
National Provider Identifier
1811005754
Registry record updated Jun 17, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Critical Care Medicine PhysicianTaxonomy code 2080P0203X
Legal business name
WEILL MEDICAL COLLEGE OF CORNELL
Practice address
575 Lexington Ave
Suite 500
New York, NY 10022-6102
Phone
(212) 590-5151
Fax
(212) 590-5798
NPI assigned
Aug 29, 2006
Organization subpart
No

Authorized official

NPPES NPI Registry
Name
Paige Butler
Title
Assistant Director
Phone
(212) 590-5151

Other NPIs on the same Medicare enrollment 1

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

Practitioners 12

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
33D2345790Weill Cornell Medical College of Cornell575 Lexington Ave - 5TH FL, New York, NY 10022Provider-performed microscopyMar 26, 2027

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040719001355 NY Part B Supplier - Clinic/Group Practice 6800709023 Receives reassigned benefits from 12 practitioners
1 other NPI on this enrollment
Practice locations: New York, NY

National Provider Directory

National Provider Directory
Tax ID family
Edwina Sai Kho90 organizations share this tax ID, including this one

Organizations with this tax ID in the same state 24

This tax ID family is large, so up to 24 of its organizations in the same state are linked here.

View all 24

Specialties & licenses 1

NPPES NPI Registry
Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Critical Care Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 2080P0203X Primary

Addresses

NPPES NPI Registry

Primary practice location

575 Lexington Ave
Suite 500
New York, NY 10022-6102

Mailing address

525 E 68TH St
Box 585
New York, NY 10021-4870
Phone (212) 746-3558

Other identifiers 1

NPPES NPI Registry
IdentifierTypeStateIssuer
02691638MedicaidNY

Other names 1

NPPES NPI Registry
  • Cornell Pediatric Intensive Care Doing business as

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Jun 17, 2014.

{
    "created_epoch": "1156809600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1402963200000",
    "number": "1811005754",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "525 E 68TH ST",
            "address_2": "BOX 585",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100214870",
            "telephone_number": "212-746-3558",
            "fax_number": "212-746-3988"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "575 LEXINGTON AVE",
            "address_2": "SUITE 500",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100226102",
            "telephone_number": "212-590-5151",
            "fax_number": "212-590-5798"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WEILL MEDICAL COLLEGE OF CORNELL",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-29",
        "last_updated": "2014-06-17",
        "status": "A",
        "authorized_official_last_name": "BUTLER",
        "authorized_official_first_name": "PAIGE",
        "authorized_official_title_or_position": "ASSISTANT DIRECTOR",
        "authorized_official_telephone_number": "212-590-5151"
    },
    "taxonomies": [
        {
            "code": "2080P0203X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Pediatrics, Pediatric Critical Care Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02691638",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Cornell Pediatric Intensive Care",
            "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 Jun 17, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.