Individual provider Active NPI

Nelly Katsnelson, MD

  • Psychiatry Physician
  • Bronx, NY
National Provider Identifier
1831269950
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
177524 Issued in NY
Practice address
MMC - Dept. of Psychiatry
111 East 210TH Street, Klau 1
Bronx, NY 10467
Phone
(718) 920-4295
NPI assigned
Nov 8, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician 2084P0800X 177524 NY Primary

Addresses

Primary practice location

MMC - Dept. of Psychiatry
111 East 210TH Street, Klau 1
Bronx, NY 10467

Mailing address

525 E 89TH St
New York, NY 10128-7834
Phone (718) 920-4295

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
I20071019000241 NY Practitioner - Psychiatry 7012003239 Reassigns benefits to 1 organization
Practice locations: Bronx, NY; New York, NY

Care Compare profile

Medicare Care Compare
Specialty
Psychiatry
Education
Michigan State University College of Human Medicine, 1987
Medicare assignment
May accept Medicare assignment
Telehealth
Offers telehealth services
Group practices
Montefiore Medical CenterGroup PAC ID 3779496021, 2,809 clinicians

Practice addresses (Care Compare)

111 E 210TH St
Bronx, NY 10467-2401
Phone (866) 633-8255

Hospital & facility affiliations

  • Montefiore Medical Center Hospital, Bronx, NY, CCN 330059

Merit-based Incentive Payment System (MIPS)

Final score
100 of 100Reported as group
Promoting interoperability
100
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
177524NYMDPsychiatry Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Montefiore Medical Center CurrentSince Dec 29, 2011 Accepting new patients
Montefiore Medical Center Psychiatry CurrentSince Dec 29, 2011 Accepting new patients
Montefiore Medical Center Past Accepting new patients

Locations

111 E 210th St
Bronx, NY 10467

111 E 210th St
#1
Bronx, NY 10467
Phone (718) 920-4057

1055 E Tremont Ave
Bronx, NY 10460
Phone (718) 842-8040

111 E 210th St
Rm 25
Bronx, NY 10467
Phone (718) 920-4298

Networks

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

Organizations & group practices 3

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.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1162944000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1831269950",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "525 E 89TH ST",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "101287834",
            "telephone_number": "718-920-4295",
            "fax_number": "718-920-6538"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "MMC - DEPT. OF PSYCHIATRY",
            "address_2": "111 EAST 210TH STREET, KLAU 1",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "10467",
            "telephone_number": "718-920-4295"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KATSNELSON",
        "first_name": "NELLY",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-11-08",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "NY",
            "license": "177524",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bronx, NY

Sources for this page

Verify at the official NPI Registry.