Individual provider Active NPI

James Elie I

  • Peer Specialist
  • Ny, NY
National Provider Identifier
1871250753
Registry record updated Nov 26, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Peer SpecialistTaxonomy code 175T00000X
License
416999068 Issued in NY
Practice address
135West50Thstreet6Thfloor
Ny, NY 10020
Phone
(212) 582-9100
NPI assigned
Nov 26, 2021
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 26, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Peer Specialist 175T00000X 416999068 NY Primary

Addresses

Primary practice location

135West50Thstreet6Thfloor
Ny, NY 10020

Mailing address

988 E 180TH St Apt 14J
Bronx, NY 10460-2383
Phone (646) 812-5470

Other identifiers 1

IdentifierTypeStateIssuer
175T00000XMedicaidNY

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
416999068NYMDPeer Specialist

NPI Registry JSON

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

{
    "created_epoch": "1637884800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1637884800000",
    "number": "1871250753",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "988 E 180TH ST APT 14J",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "104602383",
            "telephone_number": "646-812-5470"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "135WEST50THSTREET6THFLOOR",
            "city": "NY",
            "state": "NY",
            "postal_code": "10020",
            "telephone_number": "212-582-9100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ELIE",
        "first_name": "JAMES",
        "name_prefix": "Mr.",
        "name_suffix": "I",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2021-11-26",
        "last_updated": "2021-11-26",
        "certification_date": "2021-11-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "175T00000X",
            "taxonomy_group": "",
            "desc": "Peer Specialist",
            "state": "NY",
            "license": "416999068",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "175T00000X",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Ny, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 26, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.