Individual provider Active NPI

Ephraim Leiderman, M.D.

  • Internal Medicine Physician
  • Bronx, NY
National Provider Identifier
1841743960
Registry record updated Jun 18, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
296357 Issued in NY
Practice address
1400 Pelham Parkway South
Jacobi Medical Center
Bronx, NY 10461
Phone
(516) 359-1884
NPI assigned
Jul 25, 2016
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 18, 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 296357 NY Primary

Addresses

Primary practice location

1400 Pelham Parkway South
Jacobi Medical Center
Bronx, NY 10461

Mailing address

1400 Pelham Parkway South
Jacobi Medical Center
Bronx, NY 10461
Phone (516) 359-1884

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
I20190826001618 NY Order and Referring Only - Internal MedicinePractitioner - Internal Medicine 5799013934

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
296357NYMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
New York City Health and Hospitals Corporation Internal Medicine Past Accepting new patients

Networks

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

Interoperability endpoints

  • Direct secure messaging: eleiderman842226@nychhc.direct-ci.com

Organizations & group practices 1

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": "1469404800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1560816000000",
    "number": "1841743960",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1400 PELHAM PARKWAY SOUTH",
            "address_2": "JACOBI MEDICAL CENTER",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "10461",
            "telephone_number": "516-359-1884"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1400 PELHAM PARKWAY SOUTH",
            "address_2": "JACOBI MEDICAL CENTER",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "10461",
            "telephone_number": "516-359-1884"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEIDERMAN",
        "first_name": "EPHRAIM",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-07-25",
        "last_updated": "2019-06-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NY",
            "license": "296357",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bronx, NY

Sources for this page

Verify at the official NPI Registry.