Individual provider Active NPI

Damani Colin Taylor, M.D.

  • Pediatrics Physician
  • New York, NY
National Provider Identifier
1992091052
Registry record updated Aug 15, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
275122 Issued in NY
Practice address
55 Water St FL 46
New York, NY 10041-3211
Phone
(212) 649-5555
NPI assigned
Jun 27, 2011
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 15, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Hospice and Palliative Medicine Physician 2080H0002X 275122 NY
Pediatrics Physician 208000000X 275122 NY Primary

Addresses

Primary practice location

55 Water St FL 46
New York, NY 10041-3211

Mailing address

55 Water St FL 46
New York, NY 10041-3211
Phone (212) 649-5555

Other practice location 1

1275 York Ave
Box 8
New York, NY 10065-6007
Phone (646) 888-3460

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20150925002393 NY Practitioner - Pediatric MedicinePractitioner - Hospice/Palliative Care 5799093613 Reassigns benefits to 2 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
275122NYMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Memorial Pediatric Group Pediatrics CurrentSince Jul 1, 2015 Accepting new patients
MJHS Medical Associates CurrentSince Jan 23, 2019 Accepting new patients

Locations

55 Water St
Fl 46
New York, NY 10041
Phone (212) 440-1943

1275 York Ave
New York, NY 10065
Phone (212) 639-3813

1275 York Ave
#8
New York, NY 10065
Phone (212) 639-2282

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": "1309132800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1692057600000",
    "number": "1992091052",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "55 WATER ST FL 46",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100413211",
            "telephone_number": "212-649-5555"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "55 WATER ST FL 46",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100413211",
            "telephone_number": "212-649-5555"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1275 York Ave",
            "address_2": "Box 8",
            "address_purpose": "LOCATION",
            "city": "New York",
            "state": "NY",
            "postal_code": "100656007",
            "country_code": "US",
            "telephone_number": "646-888-3460",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "TAYLOR",
        "first_name": "DAMANI",
        "middle_name": "COLIN",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-06-27",
        "last_updated": "2023-08-15",
        "certification_date": "2023-08-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2080H0002X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Hospice and Palliative Medicine",
            "state": "NY",
            "license": "275122",
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "NY",
            "license": "275122",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

Verify at the official NPI Registry.