Active NPI
Tomas Havranek, MD
- Neonatal-Perinatal Medicine Physician
- Bronx, NY
National Provider Identifier
1881604601
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Neonatal-Perinatal Medicine Physician
- License
- 216275
- Practice address
- 1601 Tenbroeck Ave
Bronx, NY 10461-2007 - Phone
- (314) 440-9242
- NPI assigned
- Aug 8, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatrics Physician | 208000000X | 2006034636 | MO | |
| Neonatal-Perinatal Medicine Physician | 2080N0001X | 2006034636 | MO | |
| Neonatal-Perinatal Medicine Physician | 2080N0001X | 216275 | NY | Primary |
Addresses
Primary practice location
1601 Tenbroeck Ave
Bronx, NY 10461-2007
Mailing address
1601 Tenbroeck Ave
Bronx, NY 10461-2007
Phone (314) 440-9242
Other practice location 1
1465 S Grand Blvd
Saint Louis, MO 63104-1003
Phone (314) 577-5642
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
Enrollment records 1
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2006034636 | MO | MD | Neonatal-Perinatal Medicine Physician |
| 216275 | NY | MD | Neonatal-Perinatal Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Montefiore Medical Center | Current | Accepting new patients | |
| Montefiore Medical Center | Pediatrics | Current | Accepting new patients |
| Stony Brook Children'S Service, University Faculty Practice Corporatio | Pediatrics | Current | Accepting new patients |
| SSM Health Care St. Louis | Pediatrics | Past | Accepting new patients |
| University Medical Service Association Inc | Past | Accepting new patients | |
| SSM Health Care St. Louis | Pediatrics | Past | Accepting new patients |
| Long Island College Hospital | Pediatrics | Past | Accepting new patients |
| University Hospital at Stony Brook | Past | Accepting new patients |
Locations
111 E 210th St
Bronx, NY 10467
2701 Sunrise Hwy
Islip Terrace, NY 11752
Phone (631) 444-6300
Networks
- Healthfirst Medicare Network H9678
- Healthfirst Medicare Network H5989
- Healthfirst Medicare Network H1722
- Healthfirst Medicare Network H3359
Organizations & group practices 8
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.
-
- Pediatrics Physician
- Stony Brook, NY
- NPI 1083660575
-
- Community/Retail Pharmacy
- Bronx, NY
- NPI 1194183715
-
- General Acute Care Hospital
- Stony Brook, NY
- NPI 1972523348
-
- Emergency Medical Services (Emergency Medicine) Physician
- Lake St Louis, MO
- NPI 1538113097
Pediatrics
-
- Durable Medical Equipment & Medical Supplies
- Tampa, FL
- NPI 1194276576
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1154995200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1694563200000",
"number": "1881604601",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1601 TENBROECK AVE",
"city": "BRONX",
"state": "NY",
"postal_code": "104612007",
"telephone_number": "314-440-9242",
"fax_number": "317-977-6777"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1601 TENBROECK AVE",
"city": "BRONX",
"state": "NY",
"postal_code": "104612007",
"telephone_number": "314-440-9242"
}
],
"practiceLocations": [
{
"address_1": "1465 S Grand Blvd",
"address_purpose": "LOCATION",
"city": "Saint Louis",
"state": "MO",
"postal_code": "631041003",
"country_code": "US",
"telephone_number": "314-577-5642",
"fax_number": "314-268-6410",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "HAVRANEK",
"first_name": "TOMAS",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-08-08",
"last_updated": "2023-09-13",
"certification_date": "2023-09-13",
"status": "A"
},
"taxonomies": [
{
"code": "208000000X",
"taxonomy_group": "",
"desc": "Pediatrics",
"state": "MO",
"license": "2006034636",
"primary": false
},
{
"code": "2080N0001X",
"taxonomy_group": "",
"desc": "Pediatrics, Neonatal-Perinatal Medicine",
"state": "MO",
"license": "2006034636",
"primary": false
},
{
"code": "2080N0001X",
"taxonomy_group": "",
"desc": "Pediatrics, Neonatal-Perinatal Medicine",
"state": "NY",
"license": "216275",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Bronx, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 13, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.