NPIMap

Organization Active NPI

Icahn School of Medicine at Mount Sinai

  • Diagnostic Radiology Physician
  • Oceanside, NY
National Provider Identifier
1811511702
Registry record updated Jun 9, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
Legal business name
ICAHN SCHOOL OF MEDICINE AT MOUNT SINAI
Practice address
185 Merrick Rd
Oceanside, NY 11572-1431
Phone
(516) 766-6550
NPI assigned
Jun 5, 2020
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 9, 2022

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

Authorized official

Name
Punita Darji
Title
Finance Manager
Phone
(646) 634-9814

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Radiology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 2085R0202X Primary
Physiological Laboratory 293D00000X

Addresses

Primary practice location

185 Merrick Rd
Oceanside, NY 11572-1431

Mailing address

150 East 42ND Street
5TH Floor, 5.a.30.6
New York, NY 10017
Phone (646) 605-4113

Other names 1

  • MOUNT SINAI SN HOSPITAL PHYSICIANS-RALI IDTF Other name

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20210412000123 NY Part B Supplier - Independent Diagnostic Testing Facility (Idtf) 8527473479 Practice locations: Oceanside, NY

Other NPIs with the same Medicare PAC ID 2

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

National Provider Directory

National Provider Directory
Tax ID family
Icahn School of Medicine at Mount Sinai5 organizations share this tax ID, including this one

Other organizations with this tax ID 4

Organizations that report the same tax identification number in the National Provider Directory.

Locations

325 E Bay Dr
Long Beach, NY 11561
Phone (516) 255-1600

Practitioners & affiliated clinicians

Practitioners 19

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

View all 19

NPI Registry JSON

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

{
    "created_epoch": "1591315200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1654732800000",
    "number": "1811511702",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "150 EAST 42ND STREET",
            "address_2": "5TH FLOOR, 5.A.30.6",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "10017",
            "telephone_number": "646-605-4113"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "185 MERRICK RD",
            "city": "OCEANSIDE",
            "state": "NY",
            "postal_code": "115721431",
            "telephone_number": "516-766-6550"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ICAHN SCHOOL OF MEDICINE AT MOUNT SINAI",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-06-05",
        "last_updated": "2022-06-09",
        "certification_date": "2022-06-09",
        "status": "A",
        "authorized_official_last_name": "DARJI",
        "authorized_official_first_name": "PUNITA",
        "authorized_official_title_or_position": "FINANCE MANAGER",
        "authorized_official_telephone_number": "646-634-9814"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Radiology, Diagnostic Radiology",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "293D00000X",
            "taxonomy_group": "",
            "desc": "Physiological Laboratory",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "MOUNT SINAI SN HOSPITAL PHYSICIANS-RALI IDTF",
            "code": "5",
            "type": "Other Name"
        },
        {
            "organization_name": "MOUNT SINAI SN HOSPITAL PHYSICIANS-RALI IDTF",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Oceanside, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 9, 2022; 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.