Individual provider Active NPI

Maria Camila Fonseca Mora, MD

  • Internal Medicine Physician
  • New York, NY
National Provider Identifier
1831659879
Registry record updated Mar 29, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
333321 Issued in NY
Practice address
1901 1St Ave FL 11
New York, NY 10029-7491
Phone
(212) 423-6771
NPI assigned
Mar 25, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 29, 2025

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery Physician 208600000X 25673 FL
Student in an Organized Health Care Education/Training Program 390200000X
Student in an Organized Health Care Education/Training Program 390200000X NY
Internal Medicine Physician 207R00000X 333321 NY Primary

Addresses

Primary practice location

1901 1St Ave FL 11
New York, NY 10029-7491

Mailing address

760 Broadway
Brooklyn, NY 11206-5317
Phone (917) 213-0992

Other practice location 1

506 Lenox Ave
New York, NY 10037-1802
Phone (212) 939-1641

Other practice location 2

2950 Cleveland Clinic Blvd
Weston, FL 33331-3625
Phone (917) 213-0992

Other practice location 3

506 Lenox Ave
New York, NY 10037-1802
Phone (212) 939-3536

Other practice location 4

760 Broadway
Brooklyn, NY 11206-5317
Phone (718) 963-5807

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
333321NYMDInternal Medicine Physician
25673FLMDPhysical Therapy Assistant

NPI Registry JSON

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

{
    "created_epoch": "1553472000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1743206400000",
    "number": "1831659879",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "760 BROADWAY",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112065317",
            "telephone_number": "917-213-0992"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1901 1ST AVE FL 11",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100297491",
            "telephone_number": "212-423-6771"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "506 Lenox Ave",
            "address_purpose": "LOCATION",
            "city": "New York",
            "state": "NY",
            "postal_code": "100371802",
            "country_code": "US",
            "telephone_number": "212-939-1641",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2950 Cleveland Clinic Blvd",
            "address_purpose": "LOCATION",
            "city": "Weston",
            "state": "FL",
            "postal_code": "333313625",
            "country_code": "US",
            "telephone_number": "917-213-0992",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "506 Lenox Ave",
            "address_purpose": "LOCATION",
            "city": "New York",
            "state": "NY",
            "postal_code": "100371802",
            "country_code": "US",
            "telephone_number": "212-939-3536",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "760 Broadway",
            "address_purpose": "LOCATION",
            "city": "Brooklyn",
            "state": "NY",
            "postal_code": "112065317",
            "country_code": "US",
            "telephone_number": "718-963-5807",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "FONSECA MORA",
        "first_name": "MARIA",
        "middle_name": "CAMILA",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-03-25",
        "last_updated": "2025-03-29",
        "certification_date": "2025-03-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "FL",
            "license": "25673",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "NY",
            "license": null,
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NY",
            "license": "333321",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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 Mar 29, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.