Individual provider Active NPI

Aliva De, M.D.

  • Pediatric Pulmonology Physician
  • Bronx, NY
National Provider Identifier
1821287301
Registry record updated Feb 7, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Pulmonology PhysicianTaxonomy code 2080P0214X
License
274876-1 Issued in NY
Practice address
3415 Bainbridge Ave
Bronx, NY 10467-2403
Phone
(718) 515-2330
Fax
(718) 515-2608
NPI assigned
Oct 19, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 7, 2018

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Pediatric Pulmonology Physician 2080P0214X 274876-1 NY Primary

Addresses

Primary practice location

3415 Bainbridge Ave
Bronx, NY 10467-2403

Mailing address

3415 Bainbridge Ave
Bronx, NY 10467-2403
Phone (718) 515-2330

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY, NJ2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20140917002608 NY Practitioner - Pediatric MedicinePractitioner - Pulmonary Disease 6709005127 Reassigns benefits to 3 organizations
I20221012002686 NJ Practitioner - Pediatric Medicine 6709005127 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Pediatric MedicineAlso: Pulmonary Disease
Education
Other, 2004
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

622 W 168TH St
New York, NY 10032-3720
Phone (646) 317-7111

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
274876-1NYMDPediatric Pulmonology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Trustees of Columbia University in the City of New York CurrentSince Dec 1, 2018 Accepting new patients
Montefiore Medical Center CurrentSince Aug 14, 2014 Accepting new patients
Harlem Medical Associates PC CurrentSince Oct 13, 2019 Accepting new patients
Trustees of Columbia University in the City of New York CurrentSince Dec 1, 2018 Accepting new patients
Columbia Doctors of New Jersey, P. C. CurrentSince Jul 1, 2022 Accepting new patients
Montefiore Medical Center CurrentSince Aug 14, 2014 Accepting new patients
Columbia Doctors of New Jersey, P. C. CurrentSince Jul 1, 2022 Accepting new patients
Trustees of Columbia University in the Department of Otolaryngology Past Accepting new patients

Locations

500 Grand Ave
Fl 1
Englewood, NJ 07631
Phone (201) 227-1760

400 Kelby St
Ste 9
Fort Lee, NJ 07024

223 N Van Dien Ave
Ridgewood, NJ 07450
Phone (201) 447-8417

111 E 210th St
Bronx, NY 10467

728 N Main St
New Square, NY 10977
Phone (845) 354-9301

3959 Broadway
New York, NY 10032
Phone (212) 304-7297

506 Malcolm X Blvd
New York, NY 10037
Phone (212) 939-1000

622 W 168th St
Ph 3303
New York, NY 10032
Phone (212) 305-2654

622 W 168th St
New York, NY 10032
Phone (212) 305-4931

161 Fort Washington Ave
New York, NY 10032
Phone (212) 305-8559

Networks

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

Interoperability endpoints

  • Direct secure messaging: ald9126@direct.nyp.org
  • FHIR API: https://epicproxy-pub.et1089.epichosted.com/FHIRProxy/api/FHIR/R4/
  • Direct secure messaging: ade1043913@nychhc.direct-ci.com
  • FHIR API: https://epicproxy-pub.et1089.epichosted.com/FHIRProxy/api/FHIR/DSTU2/

Organizations & group practices 8

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": "1192752000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1517961600000",
    "number": "1821287301",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3415 BAINBRIDGE AVE",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "104672403",
            "telephone_number": "718-515-2330",
            "fax_number": "718-515-2608"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3415 BAINBRIDGE AVE",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "104672403",
            "telephone_number": "718-515-2330",
            "fax_number": "718-515-2608"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DE",
        "first_name": "ALIVA",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-10-19",
        "last_updated": "2018-02-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2080P0214X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Pulmonology",
            "state": "NY",
            "license": "274876-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bronx, NY

Sources for this page

Verify at the official NPI Registry.