Active NPI
Malcolm Gilbert Idelson, M.D.
- Obstetrics & Gynecology Physician
- Pleasant Valley, NY
National Provider Identifier
1962740092
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Obstetrics & Gynecology Physician
- License
- 080056-1
- Practice address
- 30 Pond Hills Court
Pleasant Valley, NY 12569 - Phone
- (845) 635-9132
- Fax
- (845) 635-1381
- NPI assigned
- Jan 24, 2013
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Obstetrics & Gynecology Physician | 207V00000X | 080056-1 | NV | Primary |
| Gynecologic Oncology Physician | 207VX0201X | 080056-1 | NY |
Addresses
Primary practice location
30 Pond Hills Court
Pleasant Valley, NY 12569
Mailing address
30 Pond Hills Court
Pleasant Valley, NY 12569
Phone (845) 635-9132
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| #080056-1 | Other | NY | PHYSICIAN MEDICAL LICENSE |
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)
- Not enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 080056-1 | NV | MD | Obstetrics & Gynecology Physician |
| 080056-1 | NY | MD | Gynecologic Oncology Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1358985600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1678147200000",
"number": "1962740092",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "30 POND HILLS COURT",
"city": "PLEASANT VALLEY",
"state": "NY",
"postal_code": "12569",
"telephone_number": "845-635-9132",
"fax_number": "845-635-1381"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "30 POND HILLS COURT",
"city": "PLEASANT VALLEY",
"state": "NY",
"postal_code": "12569",
"telephone_number": "845-635-9132",
"fax_number": "845-635-1381"
}
],
"practiceLocations": [],
"basic": {
"last_name": "IDELSON",
"first_name": "MALCOLM",
"middle_name": "GILBERT",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2013-01-24",
"last_updated": "2023-03-07",
"status": "A"
},
"taxonomies": [
{
"code": "207V00000X",
"taxonomy_group": "",
"desc": "Obstetrics & Gynecology",
"state": "NV",
"license": "080056-1",
"primary": true
},
{
"code": "207VX0201X",
"taxonomy_group": "",
"desc": "Obstetrics & Gynecology, Gynecologic Oncology",
"state": "NY",
"license": "080056-1",
"primary": false
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "PHYSICIAN MEDICAL LICENSE",
"identifier": "#080056-1",
"state": "NY"
}
],
"endpoints": [],
"other_names": []
}Other providers in Pleasant Valley, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 7, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.