Active NPI
Mirella Mourad, M.D.
- Maternal & Fetal Medicine Physician
- New York, NY
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Maternal & Fetal Medicine Physician
- License
- 277176-1
- Practice address
- 622 W 168TH St
New York, NY 10032-3720 - Phone
- (212) 305-3151
- NPI assigned
- May 16, 2011
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Maternal & Fetal Medicine Physician | 207VM0101X | 277176-1 | NY | Primary |
Addresses
Primary practice location
622 W 168TH St
New York, NY 10032-3720
Mailing address
622 W 168TH St
New York, NY 10032-3720
Phone (347) 880-0282
Other practice location 1
465 Main St
Apt. 2E
New York, NY 10044-0097
Phone (347) 880-0282
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
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Obstetrics/Gynecology
- Education
- Other, 2008
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Trustees of Columbia University in the City of New York
Practice addresses (Care Compare)
622 W 168TH St
New York, NY 10032-3720
Phone (212) 305-4931
622 W 168TH St
New York, NY 10032-3796
Phone (646) 317-7111
Merit-based Incentive Payment System (MIPS)
- Final score
- 100 of 100
- Quality
- 85.32
- Promoting interoperability
- 100
- Improvement activities
- 40
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 277176 | NY | MD | Licensed Practical Nurse |
| 277176-1 | NY | MD | Maternal & Fetal Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Trustees of Columbia University in the City of New York | Current | Accepting new patients | |
| Trustees of Columbia University in the City of New York | Current | Accepting new patients | |
| Trustees of Columbia University in the City of New York | Current | Accepting new patients | |
| The New York and Presbyterian Hospital | Past | Accepting new patients | |
| Trustees of Columbia University in the Department of Otolaryngology | Past | Accepting new patients |
Locations
4 Studio Arc
Bronxville, NY 10708
Phone (914) 337-2022
5 Columbus Cir
Fl 12
New York, NY 10019
Phone (212) 305-4636
51 W 51st St
Frnt 3
New York, NY 10019
Phone (212) 305-9012
622 W 168th St
#4C408
New York, NY 10032
Phone (646) 317-7111
3959 Broadway
New York, NY 10032
Phone (212) 304-7297
622 W 168th St
New York, NY 10032
Phone (212) 305-4931
161 Fort Washington Ave
New York, NY 10032
Phone (212) 305-8559
161 Fort Washington Ave
Fl 4
New York, NY 10032
Phone (212) 305-3410
Networks
- Healthfirst Medicare Network H9678
- Healthfirst Medicare Network H5989
- Healthfirst Medicare Network H1722
- Healthfirst Medicare Network H3359
Interoperability endpoints
- mim7019@direct.nyp.org
- https://epicproxy-pub.et1089.epichosted.com/FHIRProxy/api/FHIR/R4/
- https://epicproxy-pub.et1089.epichosted.com/FHIRProxy/api/FHIR/DSTU2/
Organizations & group practices 5
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.
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- Surgery Physician
- New York, NY
- NPI 1508266347
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- Internal Medicine Physician
- Fort Lee, NJ
- NPI 1982993184
NY
-
- Internal Medicine Physician
- New York, NY
- NPI 1699289488
-
dba NewYork-Presbyterian Hospital
- General Acute Care Hospital
- New York, NY
- NPI 1194832477
-
- Specialist
- New York, NY
- NPI 1801074315
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1305504000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1524009600000",
"number": "1841583473",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "622 W 168TH ST",
"city": "NEW YORK",
"state": "NY",
"postal_code": "100323720",
"telephone_number": "347-880-0282"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "622 W 168TH ST",
"city": "NEW YORK",
"state": "NY",
"postal_code": "100323720",
"telephone_number": "212-305-3151"
}
],
"practiceLocations": [
{
"address_1": "465 Main St",
"address_2": "Apt. 2E",
"address_purpose": "LOCATION",
"city": "New York",
"state": "NY",
"postal_code": "100440097",
"country_code": "US",
"telephone_number": "347-880-0282",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "MOURAD",
"first_name": "MIRELLA",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2011-05-16",
"last_updated": "2018-04-18",
"status": "A"
},
"taxonomies": [
{
"code": "207VM0101X",
"taxonomy_group": "",
"desc": "Obstetrics & Gynecology, Maternal & Fetal Medicine",
"state": "NY",
"license": "277176-1",
"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 Apr 18, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.