NPIMap

Organization Active NPI

Weill Medical College of Cornell

Doing business as Dept. of Psychiatry

  • Psychologist
  • New York, NY
National Provider Identifier
1871692210
Registry record updated Oct 25, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
Legal business name
WEILL MEDICAL COLLEGE OF CORNELL
Doing business as
Dept. of Psychiatry
Practice address
525 East 68TH Sreet
Box 171 RM F-1228 Dept. of Pyschiatry
New York, NY 10065-4870
Phone
(212) 746-0235
Fax
(212) 746-3687
NPI assigned
Sep 22, 2006
Last updated
Oct 25, 2017By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 25, 2017

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

Authorized official

Name
Zemfira Egelbaum
Title
Account Supervisor
Phone
(212) 746-0235

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychologist 103T00000X Primary

Addresses

Primary practice location

525 East 68TH Sreet
Box 171 RM F-1228 Dept. of Pyschiatry
New York, NY 10065-4870

Mailing address

525 East 68TH Sreet
Box 171 RM F-1228 Dept. of Pyschiatry
New York, NY 10065-4870
Phone (212) 746-0235

Other identifiers 1

IdentifierTypeStateIssuer
02204644MedicaidNY

Other names 1

  • Dept. of Psychiatry Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040712000830 NY Part B Supplier - Clinic/Group Practice 6800709023 Receives reassigned benefits from 171 practitioners
Practice locations: New York, NY; White Plains, NY

National Provider Directory

National Provider Directory

Locations

525 E 68th St
Rm F1228
New York, NY 10065
Phone (212) 746-0235

Practitioners & affiliated clinicians

Practitioners 203

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 203

NPI Registry JSON

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

{
    "created_epoch": "1158883200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1508889600000",
    "number": "1871692210",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "525 EAST 68TH SREET",
            "address_2": "BOX 171 RM F-1228 DEPT. OF PYSCHIATRY",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100654870",
            "telephone_number": "212-746-0235",
            "fax_number": "212-746-3687"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "525 EAST 68TH SREET",
            "address_2": "BOX 171 RM F-1228 DEPT. OF PYSCHIATRY",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100654870",
            "telephone_number": "212-746-0235",
            "fax_number": "212-746-3687"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WEILL MEDICAL COLLEGE OF CORNELL",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-22",
        "last_updated": "2017-10-25",
        "status": "A",
        "authorized_official_last_name": "EGELBAUM",
        "authorized_official_first_name": "ZEMFIRA",
        "authorized_official_title_or_position": "ACCOUNT SUPERVISOR",
        "authorized_official_telephone_number": "212-746-0235"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02204644",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Dept. of Psychiatry",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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 Oct 25, 2017; 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.