Individual provider Active NPI

Edward Charles Phillips, M.D.

  • Internal Medicine Physician
  • Bronx, NY
National Provider Identifier
1841345469
Registry record updated Dec 12, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
164585 Issued in NY
Practice address
2015 Grand Concourse
Bronx, NY 10453-4303
Phone
(718) 299-7295
Fax
(718) 299-6797
NPI assigned
Jan 24, 2007
Last updated
Dec 12, 2019By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 12, 2019

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 164585 NY Primary

Addresses

Primary practice location

2015 Grand Concourse
Bronx, NY 10453-4303

Mailing address

1436 Williamsbridge Rd
Bronx, NY 10461-2507
Phone (718) 618-0401

Other identifiers 1

IdentifierTypeStateIssuer
01947680MedicaidNY

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
I20110721000533 NY Practitioner - Internal Medicine 9931377702 Reassigns benefits to 6 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
164585NYMDLicensed Practical Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
Skilled Facility Health Care Solutions Inc CurrentSince Sep 30, 2019 Accepting new patients
Kingsbrook Medical Associates, PC CurrentSince Jan 11, 2022 Accepting new patients
Hospitalist Healthcare Services PLLC Internal Medicine CurrentSince Dec 11, 2013 Accepting new patients
Bronx Medical Practice P.C. Internal Medicine CurrentSince Nov 12, 2019 Accepting new patients
Essen Medical Associates, PC Current Accepting new patients
Essen Medical Associates,PC CurrentSince Nov 12, 2019 Accepting new patients
Essen Medical Associates, PC CurrentSince Nov 12, 2019 Accepting new patients
Kingsbrook Medical Associates PC CurrentSince Jan 11, 2022 Accepting new patients
House Call Medical Services of New York, PLLC Internal Medicine CurrentSince Nov 12, 2019 Accepting new patients
Hospitalist Healthcare Services PLLC Internal Medicine CurrentSince Dec 11, 2013 Accepting new patients
Rutland Nursing Home Inc Past Accepting new patients

Locations

3746 Foothill Blvd
La Crescenta, CA 91214
Phone (323) 574-0387

99 Washington Ave
Ste 805A
Albany, NY 12210
Phone 3104455999 ext. 215

1371 Seabury Ave
Bronx, NY 10461
Phone (718) 294-6200

1436 Williamsbridge Rd
Bronx, NY 10461
Phone (646) 759-5453

2015 Grand Concourse
Bronx, NY 10453
Phone (718) 294-6200

2015 Grand Concourse
#13202
Bronx, NY 10453

2505 Grand Ave
Bronx, NY 10468
Phone (718) 295-1400

1110 Eastern Pkwy
Pier Toussaint
Brooklyn, NY 11213
Phone (718) 735-1900

585 Schenectady Ave
Brooklyn, NY 11203
Phone (718) 604-0461

6411 Beach Channel Dr
Far Rockaway, NY 11692
Phone (718) 743-2228

8989 Union Tpke
Ste A
Glendale, NY 11385
Phone (718) 746-0400

1060 Amsterdam Ave
New York, NY 10025
Phone (212) 316-7700

214 W Houston St
New York, NY 10014
Phone (212) 337-9400

420 E 76th St
New York, NY 10021
Phone (212) 434-5300

100 Lake Rd
Vly Cottage, NY 10989
Phone (845) 268-6813

3 Barker Ave
Fl 4
White Plains, NY 10601
Phone (914) 949-7900

Networks

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

Organizations & group practices 11

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1169596800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1576108800000",
    "number": "1841345469",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1436 WILLIAMSBRIDGE RD",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "104612507",
            "telephone_number": "718-618-0401",
            "fax_number": "347-479-1303"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2015 GRAND CONCOURSE",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "104534303",
            "telephone_number": "718-299-7295",
            "fax_number": "718-299-6797"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PHILLIPS",
        "first_name": "EDWARD",
        "middle_name": "CHARLES",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-01-24",
        "last_updated": "2019-12-12",
        "certification_date": "2019-12-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NY",
            "license": "164585",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01947680",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Bronx, NY

Sources for this page

Verify at the official NPI Registry.