Individual provider Active NPI

Radeyah Hack, M.D.

  • Internal Medicine Physician
  • New York, NY
National Provider Identifier
1811330871
Registry record updated Aug 10, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
283819 Issued in NY
Practice address
110 W 97TH St
New York, NY 10025-6450
Phone
(212) 749-1820
NPI assigned
Apr 9, 2013
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 10, 2021

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 283819 NY Primary

Addresses

Primary practice location

110 W 97TH St
New York, NY 10025-6450

Mailing address

110 W 97TH St
New York, NY 10025-6450
Phone (212) 749-1820

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address rhack358672@nyumc.direct-ci.com NYU Langone Hospitals

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
I20161109001646 NY Practitioner - Internal Medicine 0446539779 Reassigns benefits to 2 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
283819NYMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
William F Ryan Community Health Center Inc Current Accepting new patients
William F. Ryan Community Health Center Inc CurrentSince Sep 19, 2016 Accepting new patients
NYU Langone Hospitals CurrentSince May 1, 2020 Accepting new patients
NYU Langone Hospitals CurrentSince May 1, 2020 Accepting new patients
NYU Langone Hospitals Internal Medicine Current Accepting new patients
William F Ryan Community Health Center Inc CurrentSince Sep 19, 2016 Accepting new patients
Charles B. Wang Community Health Center, Inc. Past Accepting new patients

Locations

150 55th St
Brooklyn, NY 11220
Phone (718) 630-7185

110 W 97th St
New York, NY 10025
Phone (212) 316-7906

301 E 17th St
New York, NY 10003
Phone (212) 460-0125

14 Wall St
Fl 9
Wall Street, NY 10005
Phone (646) 501-3224

Networks

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

Interoperability endpoints

  • Direct secure messaging: rhack787524@direct.ochin.org

Organizations & group practices 7

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": "1365465600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1628553600000",
    "number": "1811330871",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "110 W 97TH ST",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100256450",
            "telephone_number": "212-749-1820"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "110 W 97TH ST",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100256450",
            "telephone_number": "212-749-1820"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HACK",
        "first_name": "RADEYAH",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2013-04-09",
        "last_updated": "2021-08-10",
        "certification_date": "2021-08-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NY",
            "license": "283819",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "rhack358672@nyumc.direct-ci.com",
            "affiliation": "Y",
            "affiliationName": "NYU Langone Hospitals",
            "address_1": "150 55th St",
            "city": "Brooklyn",
            "state": "NY",
            "country_code": "US",
            "postal_code": "112202559",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

Verify at the official NPI Registry.