NPIMap

Organization Active NPI

Compos Mentis Medical PC

  • Psychiatry Physician
  • Staten Island, NY
National Provider Identifier
1942501457
Registry record updated Nov 15, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
Legal business name
COMPOS MENTIS MEDICAL PC
Practice address
1430 Clove Rd
Staten Island, NY 10301-4300
Phone
(718) 795-8498
Fax
(718) 876-7013
NPI assigned
Nov 15, 2010
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 15, 2010

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

Authorized official

Name
Alex Mikhelson, M.DNPI 1982802906
Title
President
Phone
(718) 795-8498

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 2084P0800X Primary

Addresses

Primary practice location

1430 Clove Rd
Staten Island, NY 10301-4300

Mailing address

211 Corbin PL
Brooklyn, NY 11235-4901
Phone (718) 795-8498

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1289779200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1289779200000",
    "number": "1942501457",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "211 CORBIN PL",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112354901",
            "telephone_number": "718-795-8498",
            "fax_number": "718-976-7013"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1430 CLOVE RD",
            "city": "STATEN ISLAND",
            "state": "NY",
            "postal_code": "103014300",
            "telephone_number": "718-795-8498",
            "fax_number": "718-876-7013"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COMPOS MENTIS MEDICAL PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-11-15",
        "last_updated": "2010-11-15",
        "status": "A",
        "authorized_official_last_name": "MIKHELSON",
        "authorized_official_first_name": "ALEX",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "718-795-8498",
        "authorized_official_credential": "M.D"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Staten Island, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 15, 2010; 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.