NPIMap

Organization Active NPI

Trustees of Columbia University in the City of New York

  • Internal Medicine Physician
  • Fort Lee, NJ
National Provider Identifier
1982993184
Registry record updated Aug 25, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
Legal business name
TRUSTEES OF COLUMBIA UNIVERSITY IN THE CITY OF NEW YORK
Practice address
400 Kelby St
8TH Floor Clinical Revenue Office
Fort Lee, NJ 07024-2943
Phone
(212) 304-6408
NPI assigned
Mar 29, 2011
Last updated
Aug 25, 2014By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 25, 2014

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

Authorized official

Name
Ms. Joanne M.J. Quan
Title
Senior VP & Chief Financial Officer
Phone
(212) 342-2939

Specialties & licenses 10

Specialty (taxonomy)CodeLicenseStatePrimary
Neuromusculoskeletal Medicine & OMM Physician 204D00000X
Family Medicine Physician 207Q00000X
Internal Medicine Physician 207R00000X Primary
Obstetrics & Gynecology Physician 207V00000X
Ophthalmology Physician 207W00000X
Orthopaedic Surgery Physician 207X00000X
Otolaryngology Physician 207Y00000X
Pediatrics Physician 208000000X
Urology Physician 208800000X
General Practice Physician 208D00000X

Addresses

Primary practice location

400 Kelby St
8TH Floor Clinical Revenue Office
Fort Lee, NJ 07024-2943

Mailing address

615 W 131St St
New York, NY 10027-7922

Other identifiers 1

IdentifierTypeStateIssuer
03845145MedicaidNY

Other names 1

  • ColumbiaDoctors Ambulatory Care Network Other name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040407001360 NY Part B Supplier - Clinic/Group Practice 8527972546 Receives reassigned benefits from 1,057 practitioners
Practice locations: New York, NY

Other NPIs with the same Medicare PAC ID 9

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

National Provider Directory

National Provider Directory

Locations

400 Kelby St
Fl 8
Fort Lee, NJ 07024
Phone (212) 304-6408

615 W 131st St
New York, NY 10027

630 W 168th St
#453
New York, NY 10032
Phone (212) 305-8300

630 W 168th St
#8453
New York, NY 10032
Phone (212) 305-2254

Practitioners & affiliated clinicians

Practitioners 1,507

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 1,507

NPI Registry JSON

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

{
    "created_epoch": "1301356800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1408924800000",
    "number": "1982993184",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "615 W 131ST ST",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100277922"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "400 KELBY ST",
            "address_2": "8TH FLOOR CLINICAL REVENUE OFFICE",
            "city": "FORT LEE",
            "state": "NJ",
            "postal_code": "070242943",
            "telephone_number": "212-304-6408"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TRUSTEES OF COLUMBIA UNIVERSITY IN THE CITY OF NEW YORK",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-03-29",
        "last_updated": "2014-08-25",
        "status": "A",
        "authorized_official_last_name": "QUAN",
        "authorized_official_first_name": "JOANNE",
        "authorized_official_middle_name": "M.J.",
        "authorized_official_title_or_position": "SENIOR VP & CHIEF FINANCIAL OFFICER",
        "authorized_official_telephone_number": "212-342-2939",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "204D00000X",
            "taxonomy_group": "",
            "desc": "Neuromusculoskeletal Medicine & OMM",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207X00000X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207Y00000X",
            "taxonomy_group": "",
            "desc": "Otolaryngology",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "208800000X",
            "taxonomy_group": "",
            "desc": "Urology",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "03845145",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "ColumbiaDoctors Ambulatory Care Network",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Fort Lee, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 25, 2014; 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.