NPIMap

Organization Active NPI

Mount Sinai School of Medicine

  • Obstetrics & Gynecology Physician
  • Oceanside, NY
National Provider Identifier
1841767993
Registry record updated Jan 11, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X
Legal business name
MOUNT SINAI SCHOOL OF MEDICINE
Practice address
196 Merrick Rd
Oceanside, NY 11572-1420
Phone
(516) 255-8400
NPI assigned
Oct 26, 2018
Last updated
Jan 11, 2019By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 11, 2019

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

Authorized official

Name
Alicia Gresham
Title
VP Network Operations
Phone
(212) 659-9038

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X NU
Family Medicine Physician 207Q00000X NU
Obstetrics & Gynecology Physician 207V00000X NU Primary
Obstetrics Physician 207VX0000X NU

Addresses

Primary practice location

196 Merrick Rd
Oceanside, NY 11572-1420

Mailing address

196 Merrick Rd
Oceanside, NY 11572-1420
Phone (516) 255-8400

Other practice location 1

1 Healthy Way
Oceanside, NY 11572-1551
Phone (516) 632-3992

Other practice location 2

2900 Hempstead Tpke Ste 203
Levittown, NY 11756-1401
Phone (516) 227-3333

Other names 1

  • Mount Sinai Marathon Medical - OB/GYN Other name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20130712000368 NY Part B Supplier - Clinic/Group Practice 6406096544 Receives reassigned benefits from 385 practitioners
15 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Lynbrook, NY; Long Beach, NY; Manhasset, NY; Merrick, NY; New York, NY; Oceanside, NY; Rockville Centre, NY; Valley Stream, NY…

Other NPIs on the same Medicare enrollment 15

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

View all 15

National Provider Directory

National Provider Directory
Tax ID family
Mount Sinai Marathon Medical - Idtf18 organizations share this tax ID, including this one

Other organizations with this tax ID 17

Organizations that report the same tax identification number in the National Provider Directory.

View all 17

Practitioners & affiliated clinicians

Practitioners 18

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 18

NPI Registry JSON

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

{
    "created_epoch": "1540512000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1547164800000",
    "number": "1841767993",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "196 MERRICK RD",
            "city": "OCEANSIDE",
            "state": "NY",
            "postal_code": "115721420",
            "telephone_number": "516-255-8400"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "196 MERRICK RD",
            "city": "OCEANSIDE",
            "state": "NY",
            "postal_code": "115721420",
            "telephone_number": "516-255-8400"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1 Healthy Way",
            "address_purpose": "LOCATION",
            "city": "Oceanside",
            "state": "NY",
            "postal_code": "115721551",
            "country_code": "US",
            "telephone_number": "516-632-3992",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2900 Hempstead Tpke Ste 203",
            "address_purpose": "LOCATION",
            "city": "Levittown",
            "state": "NY",
            "postal_code": "117561401",
            "country_code": "US",
            "telephone_number": "516-227-3333",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "MOUNT SINAI SCHOOL OF MEDICINE",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-10-26",
        "last_updated": "2019-01-11",
        "status": "A",
        "authorized_official_last_name": "GRESHAM",
        "authorized_official_first_name": "ALICIA",
        "authorized_official_title_or_position": "VP NETWORK OPERATIONS",
        "authorized_official_telephone_number": "212-659-9038"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "207VX0000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology, Obstetrics",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Mount Sinai Marathon Medical - OB/GYN",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Oceanside, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 11, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.