NPIMap

Organization Active NPI

Mount Sinai School of Medicine

  • Internal Medicine Physician
  • Oceanside, NY
National Provider Identifier
1891262093
Registry record updated Jan 11, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
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 8

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X
Registered Nurse 163W00000X
Family Medicine Physician 207Q00000X
Internal Medicine Physician 207R00000X Primary
Cardiovascular Disease Physician 207RC0000X
Geriatric Medicine (Internal Medicine) Physician 207RG0300X
Infectious Disease Physician 207RI0200X
Obesity Medicine (Internal Medicine) Physician 207RB0002X

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

2750 Merrick Rd
Bellmore, NY 11710-5720
Phone (516) 409-2000

Other practice location 2

2965 Long Beach Rd
Oceanside, NY 11572-3255
Phone (516) 593-8953

Other practice location 3

325 W Park Ave
Long Beach, NY 11561-3223
Phone (516) 432-2004

Other practice location 4

761 Franklin Blvd
Long Beach, NY 11561-2450
Phone (516) 544-2351

Other practice location 5

1 S Central Ave
Valley Stream, NY 11580-5443
Phone (516) 632-3350

Other practice location 6

1420 Broadway
Hewlett, NY 11557-1321
Phone (516) 764-5455

Other practice location 7

250 Fulton Ave Fl 1
Hempstead, NY 11550-3917
Phone (516) 485-5710

Other practice location 8

2280 Grand Ave Ste 208
Baldwin, NY 11510-3110
Phone (516) 623-4800

Other practice location 9

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

Other practice location 10

185 Merrick Rd Ste B
Lynbrook, NY 11563-2700
Phone (516) 887-0077

Other practice location 11

155 W Merrick Rd
Freeport, NY 11520-3743
Phone (516) 379-3139

Other practice location 12

1436 Broadway
Hewlett, NY 11557-1405
Phone (516) 497-7422

Other names 1

  • Mount Sinai Marathon Medical - Int Med / Family Med 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

Locations

155 W Merrick Rd
Ste 204
Freeport, NY 11520
Phone (516) 867-0102

250 Fulton Ave
Fl 1
Hempstead, NY 11550
Phone (516) 485-5710

761 Franklin Blvd
Long Beach, NY 11561
Phone (516) 544-2351

185 Merrick Rd
Ste B
Lynbrook, NY 11563
Phone (516) 887-0077

Practitioners & affiliated clinicians

Practitioners 87

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 87

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": "1891262093",
    "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": "2750 Merrick Rd",
            "address_purpose": "LOCATION",
            "city": "Bellmore",
            "state": "NY",
            "postal_code": "117105720",
            "country_code": "US",
            "telephone_number": "516-409-2000",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2965 Long Beach Rd",
            "address_purpose": "LOCATION",
            "city": "Oceanside",
            "state": "NY",
            "postal_code": "115723255",
            "country_code": "US",
            "telephone_number": "516-593-8953",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "325 W Park Ave",
            "address_purpose": "LOCATION",
            "city": "Long Beach",
            "state": "NY",
            "postal_code": "115613223",
            "country_code": "US",
            "telephone_number": "516-432-2004",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "761 Franklin Blvd",
            "address_purpose": "LOCATION",
            "city": "Long Beach",
            "state": "NY",
            "postal_code": "115612450",
            "country_code": "US",
            "telephone_number": "516-544-2351",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1 S Central Ave",
            "address_purpose": "LOCATION",
            "city": "Valley Stream",
            "state": "NY",
            "postal_code": "115805443",
            "country_code": "US",
            "telephone_number": "516-632-3350",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1420 Broadway",
            "address_purpose": "LOCATION",
            "city": "Hewlett",
            "state": "NY",
            "postal_code": "115571321",
            "country_code": "US",
            "telephone_number": "516-764-5455",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "250 Fulton Ave Fl 1",
            "address_purpose": "LOCATION",
            "city": "Hempstead",
            "state": "NY",
            "postal_code": "115503917",
            "country_code": "US",
            "telephone_number": "516-485-5710",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2280 Grand Ave Ste 208",
            "address_purpose": "LOCATION",
            "city": "Baldwin",
            "state": "NY",
            "postal_code": "115103110",
            "country_code": "US",
            "telephone_number": "516-623-4800",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "196 Merrick Rd",
            "address_purpose": "LOCATION",
            "city": "Oceanside",
            "state": "NY",
            "postal_code": "115721420",
            "country_code": "US",
            "telephone_number": "516-255-8400",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "185 Merrick Rd Ste B",
            "address_purpose": "LOCATION",
            "city": "Lynbrook",
            "state": "NY",
            "postal_code": "115632700",
            "country_code": "US",
            "telephone_number": "516-887-0077",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "155 W Merrick Rd",
            "address_purpose": "LOCATION",
            "city": "Freeport",
            "state": "NY",
            "postal_code": "115203743",
            "country_code": "US",
            "telephone_number": "516-379-3139",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1436 Broadway",
            "address_purpose": "LOCATION",
            "city": "Hewlett",
            "state": "NY",
            "postal_code": "115571405",
            "country_code": "US",
            "telephone_number": "516-497-7422",
            "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": null,
            "license": null,
            "primary": false
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207RG0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Geriatric Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207RI0200X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Infectious Disease",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207RB0002X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Obesity Medicine",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Mount Sinai Marathon Medical - Int Med / Family Med",
            "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.