Individual provider Active NPI

Leonard Zimmerman, MD

  • Internal Medicine Physician
  • West Nyack, NY
National Provider Identifier
1962496935
Registry record updated Mar 15, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
1064351 Issued in NY
Practice address
2 Crosfield Ave
Suite 318
West Nyack, NY 10994-2226
Phone
(845) 353-5600
Fax
(845) 353-5668
NPI assigned
Sep 7, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 15, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 1064351 NY Primary

Addresses

Primary practice location

2 Crosfield Ave
Suite 318
West Nyack, NY 10994-2226

Mailing address

20 Grand St
3Rd Floor
Warwick, NY 10990-1035
Phone (845) 987-3952

Other identifiers 6

IdentifierTypeStateIssuer
M101118OtherAETNA/USHC
0009322OtherGHI
00186801MedicaidNY
M4473575OtherAETNA
W07721OtherMEDICARE
02242088OtherMEDICAID

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
1064351NYMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Rockland Pulmonary and Medical Associates, PC Internal Medicine Current Accepting new patients
Bon Secours Charity Health System Medical Group, P.C. Internal Medicine Past Accepting new patients

Locations

2 Crosfield Ave
Ste 318
West Nyack, NY 10994
Phone (845) 353-5600

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1126051200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1300147200000",
    "number": "1962496935",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "20 GRAND ST",
            "address_2": "3RD FLOOR",
            "city": "WARWICK",
            "state": "NY",
            "postal_code": "109901035",
            "telephone_number": "845-987-3952",
            "fax_number": "845-987-5979"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2 CROSFIELD AVE",
            "address_2": "SUITE 318",
            "city": "WEST NYACK",
            "state": "NY",
            "postal_code": "109942226",
            "telephone_number": "845-353-5600",
            "fax_number": "845-353-5668"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ZIMMERMAN",
        "first_name": "LEONARD",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-09-07",
        "last_updated": "2011-03-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NY",
            "license": "1064351",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA/USHC",
            "identifier": "M101118",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GHI",
            "identifier": "0009322",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00186801",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "M4473575",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE",
            "identifier": "W07721",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICAID",
            "identifier": "02242088",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in West Nyack, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 15, 2011; 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.