NPIMap

Individual provider Active NPI

Santiago Marcelo Thibaud, M.D.

  • Medical Oncology Physician
  • New York, NY
National Provider Identifier
1861888943
Registry record updated Aug 24, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Oncology PhysicianTaxonomy code 207RX0202X
License
294926 Issued in NY
Practice address
1470 Madison Ave
New York, NY 10029-6542
Phone
(646) 592-7803
NPI assigned
Apr 15, 2015
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 24, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 294926 NY
Medical Oncology Physician 207RX0202X 294926 NY Primary

Addresses

Primary practice location

1470 Madison Ave
New York, NY 10029-6542

Mailing address

1 Gustave Levy Place
Box 1079
New York, NY 10029-0311
Phone (646) 592-7803

Other practice location 1

325 W 15th St # Na
New York, NY 10011-5903
Phone (212) 604-6000

Other practice location 2

1 Gustave L Levy Pl
New York, NY 10029-6504
Phone (212) 241-6756

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20180907000598 NY Practitioner - Medical OncologyPractitioner - Internal Medicine 5294085593 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Medical Oncology
Education
Other, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

5 E 98TH St
Suite 6
New York, NY 10029-6501
Phone (212) 241-4812

5 E 98TH St 12TH Floor
Tisch Department of Mount Sinai
New York, NY 10029-6501
Phone (212) 241-8303

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
294926NYMDMedical Oncology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Icahn School of Medicine at Mount Sinai CurrentSince Aug 15, 2022 Accepting new patients
Icahn School of Medicine at Mount Sinai CurrentSince Aug 15, 2022 Accepting new patients
Montefiore Medical Center CurrentSince Jul 13, 2018 Accepting new patients
Montefiore Medical Center Internal Medicine CurrentSince Jul 13, 2018 Accepting new patients
Mount Sinai Hospital Past Accepting new patients
Icahn School of Medicine at Mount Sinai Past Accepting new patients

Locations

111 E 210th St
Bronx, NY 10467

325 W 15th St
New York, NY 10011
Phone (212) 523-5938

5 E 98th St
Fl 12
New York, NY 10029
Phone (212) 241-8303

1470 Madison Ave
New York, NY 10029
Phone (212) 241-0806

5 E 98th St
Fl 5
New York, NY 10029
Phone (212) 241-8234

Networks

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

Organizations & group practices 6

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.

Hospital & facility affiliations 10

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1429056000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1661299200000",
    "number": "1861888943",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 GUSTAVE LEVY PLACE",
            "address_2": "BOX 1079",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100290311",
            "telephone_number": "646-592-7803"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1470 MADISON AVE",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100296542",
            "telephone_number": "646-592-7803"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "325 W 15th St # Na",
            "address_purpose": "LOCATION",
            "city": "New York",
            "state": "NY",
            "postal_code": "100115903",
            "country_code": "US",
            "telephone_number": "212-604-6000",
            "fax_number": "212-367-0124",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1 Gustave L Levy Pl",
            "address_purpose": "LOCATION",
            "city": "New York",
            "state": "NY",
            "postal_code": "100296504",
            "country_code": "US",
            "telephone_number": "212-241-6756",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "THIBAUD",
        "first_name": "SANTIAGO",
        "middle_name": "MARCELO",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2015-04-15",
        "last_updated": "2022-08-24",
        "certification_date": "2022-08-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NY",
            "license": "294926",
            "primary": false
        },
        {
            "code": "207RX0202X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Medical Oncology",
            "state": "NY",
            "license": "294926",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

Verify at the official NPI Registry.