NPIMap

Individual provider Active NPI

Mary M O'Sullivan, M.D.

  • Pulmonary Disease Physician
  • New York, NY
National Provider Identifier
1962495788
Registry record updated Apr 29, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pulmonary Disease PhysicianTaxonomy code 207RP1001X
License
146572 Issued in NY
Practice address
1090 Amsterdam Ave
New York, NY 10025-1737
Phone
(212) 523-8672
Fax
(212) 531-7650
NPI assigned
Aug 26, 2005
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 29, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pulmonary Disease Physician 207RP1001X 146572 NY Primary

Addresses

Primary practice location

1090 Amsterdam Ave
New York, NY 10025-1737

Mailing address

150 E 42ND St FL 9
New York, NY 10017-5699
Phone (646) 605-8188

Other identifiers 1

IdentifierTypeStateIssuer
00653732MedicaidNY

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040715001160 NY Practitioner - Pulmonary Disease 0345229191 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Pulmonary Disease
Education
JS Weill Medical College, Cornell University, 1975
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

1000 10TH Ave
New York, NY 10019-1147
Phone (212) 241-9410

1111 Amsterdam Ave
New York, NY 10025-1716
Phone (212) 241-9410

200 Old Country Rd
Mineola, NY 11501-4235
Phone (516) 877-0977

440 W 114TH St
New York, NY 10025-1796
Phone (212) 523-8672

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Icahn School of Medicine at Mount Sinai Current Accepting new patients
Icahn School of Medicine at Mount Sinai Current Accepting new patients
Icahn School of Medicine at Mount Sinai CurrentSince Jan 1, 2016 Accepting new patients
Icahn School of Medicine at Mount Sinai Pulmonary Disease CurrentSince Nov 1, 2017 Accepting new patients
Icahn School of Medicine at Mount Sinai CurrentSince Nov 1, 2017 Accepting new patients
Icahn School of Medicine at Mount Sinai CurrentSince Jan 1, 2016 Accepting new patients
St Lukes Roosevelt Community Care Past Accepting new patients
Icahn School of Medicine at Mount Sinai Past Accepting new patients
Icahn School of Medicine at Mount Sinai Past Accepting new patients

Locations

200 Old Country Rd
Mineola, NY 11501
Phone (516) 408-4900

5 E 98th St
Fl 5
New York, NY 10029
Phone (212) 241-8234

1000 10th Ave
New York, NY 10019
Phone (212) 523-2369

1111 Amsterdam Ave
New York, NY 10025
Phone (212) 523-2309

150 E 42nd St
Fl 9
New York, NY 10017
Phone (646) 605-8119

1090 Amsterdam Ave
New York, NY 10025
Phone (212) 523-2211

10 Union Sq E
New York, NY 10003
Phone (212) 253-6800

425 W 59th St
Ste 9C
New York, NY 10019
Phone (212) 492-5550

Networks

  • Healthfirst Medicare Network H9678
  • Healthfirst Medicare Network H1722
  • Healthfirst Medicare Network H3359
  • Healthfirst Medicare Network H5989

Organizations & group practices 9

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.

Hospital & facility affiliations 5

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1125014400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1556496000000",
    "number": "1962495788",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "150 E 42ND ST FL 9",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100175699",
            "telephone_number": "646-605-8188",
            "fax_number": "212-523-7410"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1090 AMSTERDAM AVE",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100251737",
            "telephone_number": "212-523-8672",
            "fax_number": "212-531-7650"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "O'SULLIVAN",
        "first_name": "MARY",
        "middle_name": "M",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-08-26",
        "last_updated": "2019-04-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RP1001X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Pulmonary Disease",
            "state": "NY",
            "license": "146572",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00653732",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

Verify at the official NPI Registry.