NPIMap

Organization Active NPI

Icahn School of Medicine at Mount Sinai

  • Hematology & Oncology Physician
  • Merrick, NY
National Provider Identifier
1912499401
Registry record updated Jun 8, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Hematology & Oncology PhysicianTaxonomy code 207RH0003X
Legal business name
ICAHN SCHOOL OF MEDICINE AT MOUNT SINAI
Practice address
2209 Merrick Rd Ste 101
Merrick, NY 11566
Phone
(516) 546-5000
NPI assigned
May 31, 2018
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 8, 2018

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

Authorized official

Name
Alicia Gresham
Title
VP of Network Operations
Phone
(212) 659-9038

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Medical-Surgical Registered NurseGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 163WM0705X
Oncology Registered NurseGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 163WX0200X
Hematology & Oncology PhysicianGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 207RH0003X Primary
Radiation Oncology PhysicianGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 2085R0001X

Addresses

Primary practice location

2209 Merrick Rd Ste 101
Merrick, NY 11566

Mailing address

1 Healthy Way
Oceanside, NY 11572-1551

Other practice location 1

1 Healthy Way
Oceanside, NY 11572-1551
Phone (516) 546-5000

Other names 1

  • MOUNT SINAI DOCTORS SOUTH NASSAU - HEMATOLOGY / ONCOLOGY Other name

National Provider Directory

National Provider Directory
Tax ID family
Icahn School of Medicine at Mount Sinai8 organizations share this tax ID, including this one

Other organizations with this tax ID 7

Organizations that report the same tax identification number in the National Provider Directory.

Locations

2209 Merrick Rd
Ste 101
Merrick, NY 11566
Phone (516) 218-2510

NPI Registry JSON

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

{
    "created_epoch": "1527724800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1528416000000",
    "number": "1912499401",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 HEALTHY WAY",
            "city": "OCEANSIDE",
            "state": "NY",
            "postal_code": "115721551"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2209 MERRICK RD STE 101",
            "city": "MERRICK",
            "state": "NY",
            "postal_code": "11566",
            "telephone_number": "516-546-5000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1 Healthy Way",
            "address_purpose": "LOCATION",
            "city": "Oceanside",
            "state": "NY",
            "postal_code": "115721551",
            "country_code": "US",
            "telephone_number": "516-546-5000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "ICAHN SCHOOL OF MEDICINE AT MOUNT SINAI",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-05-31",
        "last_updated": "2018-06-08",
        "status": "A",
        "authorized_official_last_name": "GRESHAM",
        "authorized_official_first_name": "ALICIA",
        "authorized_official_title_or_position": "VP OF NETWORK OPERATIONS",
        "authorized_official_telephone_number": "212-659-9038"
    },
    "taxonomies": [
        {
            "code": "163WM0705X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Registered Nurse, Medical-Surgical",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "163WX0200X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Registered Nurse, Oncology",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207RH0003X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Internal Medicine, Hematology & Oncology",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "2085R0001X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Radiology, Radiation Oncology",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "MOUNT SINAI DOCTORS SOUTH NASSAU - HEMATOLOGY / ONCOLOGY",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Merrick, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 8, 2018; 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.