NPIMap

Organization Active NPI

Mount Sinai School of Medicine

  • Cardiovascular Disease Physician
  • Valley Stream, NY
National Provider Identifier
1942777347
Registry record updated Jan 11, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Cardiovascular Disease PhysicianTaxonomy code 207RC0000X
Legal business name
MOUNT SINAI SCHOOL OF MEDICINE
Practice address
10 E Merrick Rd Ste 207
Valley Stream, NY 11580-5800
Phone
(516) 256-2017
NPI assigned
Oct 24, 2018
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 5

Specialty (taxonomy)CodeLicenseStatePrimary
Cardiovascular Disease PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207RC0000X Primary
Clinical Cardiac Electrophysiology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207RC0001X
Interventional Cardiology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207RI0011X
Vascular Surgery PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 2086S0129X
Nurse PractitionerGroup: 193200000X MULTI-SPECIALTY GROUP 363L00000X

Addresses

Primary practice location

10 E Merrick Rd Ste 207
Valley Stream, NY 11580-5800

Mailing address

1 Healthy Way
Oceanside, NY 11572-1551

Other practice location 1

1200 W Broadway Unit 5
Hewlett, NY 11557-1913
Phone (516) 887-7000

Other practice location 2

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

Other practice location 3

440 Merrick Rd
Oceanside, NY 11572-1404
Phone (516) 255-8220

Other practice location 4

33 N Ocean Ave
Freeport, NY 11520-3049
Phone (516) 378-4949

Other practice location 5

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

Other practice location 6

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

Other practice location 7

1 Healthy Way
Oceanside, NY 11572-1551
Phone (516) 632-3670

Other names 1

  • Mount Sinai Marathon Medical - Cardiovascular 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

Practitioners & affiliated clinicians

Practitioners 27

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

View all 27

NPI Registry JSON

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

{
    "created_epoch": "1540339200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1547164800000",
    "number": "1942777347",
    "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": "10 E MERRICK RD STE 207",
            "city": "VALLEY STREAM",
            "state": "NY",
            "postal_code": "115805800",
            "telephone_number": "516-256-2017"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1200 W Broadway Unit 5",
            "address_purpose": "LOCATION",
            "city": "Hewlett",
            "state": "NY",
            "postal_code": "115571913",
            "country_code": "US",
            "telephone_number": "516-887-7000",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "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": "440 Merrick Rd",
            "address_purpose": "LOCATION",
            "city": "Oceanside",
            "state": "NY",
            "postal_code": "115721404",
            "country_code": "US",
            "telephone_number": "516-255-8220",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "33 N Ocean Ave",
            "address_purpose": "LOCATION",
            "city": "Freeport",
            "state": "NY",
            "postal_code": "115203049",
            "country_code": "US",
            "telephone_number": "516-378-4949",
            "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": "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": "1 Healthy Way",
            "address_purpose": "LOCATION",
            "city": "Oceanside",
            "state": "NY",
            "postal_code": "115721551",
            "country_code": "US",
            "telephone_number": "516-632-3670",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "MOUNT SINAI SCHOOL OF MEDICINE",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-10-24",
        "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": "207RC0000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "207RC0001X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine, Clinical Cardiac Electrophysiology",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207RI0011X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine, Interventional Cardiology",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2086S0129X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Surgery, Vascular Surgery",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Mount Sinai Marathon Medical - Cardiovascular",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Valley Stream, 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.