ICAHN SCHOOL OF MEDICINE AT MOUNT SINAI (NPI# 1619221686) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1619221686 |
| Entity Type | Organization |
| Organization Name | ICAHN SCHOOL OF MEDICINE AT MOUNT SINAI |
| Other Organization Name | MOUNT SINAI ELMHURST FACULTY PRACTICE GROUP |
| Practice Address |
7901 Broadway Rm. A1-19 Elmhurst NY 11373-1329 |
| Practice Telephone | 7183344952 |
| Practice Fax Number | 7183344815 |
| Mailing Telephone | 7183344952 |
| Mailing Fax Number | 7183344815 |
| Enumeration Date | 2012-10-30 |
| Last Update Date | 2016-05-10 |
| Authorized Official Name | DR. MARIA PILAR GONZALEZ JIMENEZ (DIRECTOR FACULTY PRACTICE GROUP) |
| Authorized Official Telephone | 7183341591 |
| Authorized Official Credential | MD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 2084S0012X |
Psychiatry & Neurology Specialization: Sleep Medicine |
Allopathic & Osteopathic Physicians | ||
| N | 2084A0401X |
Psychiatry & Neurology Specialization: Addiction Medicine |
Allopathic & Osteopathic Physicians | ||
| N | 2084V0102X |
Psychiatry & Neurology Specialization: Vascular Neurology |
Allopathic & Osteopathic Physicians | ||
| N | 2084N0402X |
Psychiatry & Neurology Specialization: Neurology with Special Qualifications in Child Neurology |
Allopathic & Osteopathic Physicians | ||
| N | 2084N0400X |
Psychiatry & Neurology Specialization: Neurology |
Allopathic & Osteopathic Physicians | ||
| N | 2085D0003X |
Radiology Specialization: Diagnostic Neuroimaging |
Allopathic & Osteopathic Physicians | ||
| N | 2085N0700X |
Radiology Specialization: Neuroradiology |
Allopathic & Osteopathic Physicians | ||
| N | 2085N0904X |
Radiology Specialization: Nuclear Radiology |
Allopathic & Osteopathic Physicians | ||
| N | 2085P0229X |
Radiology Specialization: Pediatric Radiology |
Allopathic & Osteopathic Physicians | ||
| N | 2085R0001X |
Radiology Specialization: Radiation Oncology |
Allopathic & Osteopathic Physicians | ||
| N | 2085R0204X |
Radiology Specialization: Vascular & Interventional Radiology |
Allopathic & Osteopathic Physicians | ||
| N | 2085U0001X |
Radiology Specialization: Diagnostic Ultrasound |
Allopathic & Osteopathic Physicians | ||
| Y | 2085R0202X |
Radiology Specialization: Diagnostic Radiology |
Allopathic & Osteopathic Physicians |
| Other Name | Type Code |
|---|---|
| Mount Sinai Elmhurst Faculty Practice Group | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1144844317 | Icahn School of Medicine At Mount Sinai | Physiological Laboratory | 485 Merrick Rd, Rockville Centre, NY 11570-5436 | 2020-06-03 |
| 1013489426 | Icahn School of Medicine At Mount Sinai | Internal Medicine | 11 Madison Ave # Level1b, New York, NY 10010-3643 | 2018-12-24 |
| 1013498419 | Icahn School of Medicine At Mount Sinai | Family Medicine | 1203 Avenue J Fl 2, Brooklyn, NY 11230-3669 | 2018-08-23 |
| 1912499401 | Icahn School of Medicine At Mount Sinai | Registered Nurse | 2209 Merrick Rd Ste 101, Merrick, NY 11566 | 2018-05-31 |
| 1912376633 | Icahn School of Medicine At Mount Sinai | Pathology | 16 Street At 1st Avenue, New York, NY 10003 | 2015-09-23 |
| 1437525037 | Icahn School of Medicine At Mount Sinai | Obstetrics & Gynecology | 234 E. 85th St, 3rd Floor, New York, NY 10028 | 2015-08-18 |
| 1568841930 | Icahn School of Medicine At Mount Sinai | Dermatology | 222 West 14th Street, New York, NY 10011 | 2015-05-19 |
| 1568868834 | Icahn School of Medicine At Mount Sinai | Allergy & Immunology | 55 West 34th Street, 1st Floor, New York, NY 10016 | 2014-11-13 |
| 1427493113 | Icahn School of Medicine At Mount Sinai | Clinic/Center | 1468 Madison Ave Fl 3, New York, NY 10029-6508 | 2013-05-08 |
| 1558627844 | Icahn School of Medicine At Mount Sinai | Neurological Surgery | 5 East 98 Street 7th Floor, Newyork, NY 10029-6511 | 2012-04-11 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| System for Award Management (SAM) Entities | ICAHN SCHOOL OF MEDICINE AT MOUNT SINAI | One Gustave L Levy Pl, New York, NY 10029-6504 |
| Connecticut Business Registrations | Icahn School of Medicine At Mount Sinai Inc. | One Gustave L. Levy Place, New York, NY 10029 |
| Street Address |
7901 BROADWAY RM. A1-19 |
| City | ELMHURST |
| State | NY |
| Zip Code | 11373-1329 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1912903006 | Sambasiva Kamineni | Surgery | 7901 Broadway, Elmhurst, NY 11373-1329 | 2005-06-22 |
| 1336748433 | Lina Maria Rodriguez | Social Worker | 7901 Broadway, Elmhurst, NY 11373-1329 | 2020-10-20 |
| 1366049694 | Reinelda Glizel Diaz | Physical Therapist | 7901 Broadway, Elmhurst, NY 11373-1329 | 2020-10-09 |
| 1831796705 | Keysha Latanya Bonheur | Registered Nurse | 7901 Broadway, Elmhurst, NY 11373-1329 | 2020-10-05 |
| 1053927657 | Puja Rai | Occupational Therapist | 7901 Broadway, Elmhurst, NY 11373-1329 | 2020-09-18 |
| 1619582764 | Tenzin Wangmo | Nurse Practitioner | 7901 Broadway, Elmhurst, NY 11373-1329 | 2020-09-14 |
| 1629683578 | Carmen Maria Chavez Fuenmayor | Student in an Organized Health Care Education/Training Program | 7901 Broadway, Elmhurst, NY 11373-1329 | 2020-09-08 |
| 1093329179 | Dharma Dilia Herrera Vasquez | Student in an Organized Health Care Education/Training Program | 7901 Broadway, Elmhurst, NY 11373-1329 | 2020-09-04 |
| 1366054975 | Mackenzie Jameson | Social Worker | 7901 Broadway, Elmhurst, NY 11373-1329 | 2020-08-17 |
| 1639788201 | Nina Mariana Magdalena Andrias-ng | Registered Nurse | 7901 Broadway, Elmhurst, NY 11373-1329 | 2020-07-29 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1376152736 | Carlos Eduardo Hallo Carrasco | Student in an Organized Health Care Education/Training Program | 79-01 Broadway, 10, C 10-19a, Elmhurst, NY 11373 | 2020-07-30 |
| 1912524034 | Jurian Feygen Kaunang | Student in an Organized Health Care Education/Training Program | Bronx-lebanon Hospital Center, 1650 Grand Concourse, Bronx, NY 11373 | 2020-07-06 |
| 1407471352 | Shreeya Parajull | Student in an Organized Health Care Education/Training Program | 79-01 Broadway Elmhurst Hospital Center:, Room A7-34, Elmhurst, NY 11373 | 2020-06-16 |
| 1114542479 | Mahmud Omar Elfituri | Student in an Organized Health Care Education/Training Program | 79-01 Boradway, Elmhurst, NY 11373 | 2020-06-12 |
| 1568091452 | Nudjarin Unsin | Licensed Practical Nurse | 7517 41stave, Apt.f3, Elmhurst, NY 11373 | 2020-04-03 |
| 1154969053 | Joshua Reyes | Physician Assistant | 8839 Saint James Ave, Elmhurst, NY 11373 | 2019-12-11 |
| 1821647926 | Shahorin Monzoor | Student in an Organized Health Care Education/Training Program | 81 14 Queens Boulavard, 1st Floor, Elmhurst, NY 11373 | 2019-09-11 |
| 1174184600 | Zoila Josefina Cano Rodriguez | Student in an Organized Health Care Education/Training Program | 7802 41st Ave, Elmhurst, NY 11373 | 2019-06-25 |
| 1891355756 | Kanghee Cho | Registered Nurse | 4143 77th St Elmhurst, Elmhurst, NY 11373 | 2019-06-13 |
| 1861971947 | Allen G Luke | Acupuncturist | 86-21 53 Ave, Elmhurst, NY 11373 | 2018-08-09 |
| Find all providers in zip 11373 | ||||
| Taxonomy Code | 2085R0202X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Radiology |
| Specialization | Diagnostic Radiology |
| A radiologist who utilizes x-ray, radionuclides, ultrasound and electromagnetic radiation to diagnose and treat disease. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Radiology, 2007. http://www.theabr.org/. American Osteopathic Board of Radiology, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Radiology. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Radiology. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1811268790 | Nicholas C Burriesci | Radiology | 119 N Haven Rd, Elmhurst, IL 60126-2931 | 2012-01-24 |
| 1609194810 | Nishant Kumar | Radiology | 155 E. Brush Hill Road, Elmhurst, IL 60126-5652 | 2010-05-12 |
| 1962551895 | Angelo Peter Malamis | Radiology | 558 S Cedar Ave, Elmhurst, IL 60126-4136 | 2007-01-09 |
| 1184643561 | Khaleda Billah | Radiology | 4036 74th St, Elmhurst, NY 11373-5630 | 2006-07-18 |
| 1841248689 | Jay D Tartell | Radiology | 8940 56th Ave, Elmhurst, NY 11373-4933 | 2006-05-04 |
| 1578564696 | Djordje Boskov | Radiology | 566 S Hillcrest Ave, Elmhurst, IL 60126-4146 | 2005-08-10 |
| 1942685649 | Comprehensive Diagnostic Imaging Services P.C. | Radiology | 8635 Queens Blvd, Suite 2lm, Elmhurst, NY 11373-4434 | 2015-07-23 |
| 1417367921 | New York Radiology PC | Radiology | 5718 Junction Blvd, Elmhurst, NY 11373-5153 | 2014-05-06 |
| 1376814863 | Apollo Medical Diagnostic Services Pllc | Radiology | 4036 74th St, Elmhurst, NY 11373-5630 | 2012-01-16 |
| 1194984914 | Scott Michael Stickles | Radiology | 8940 56th Ave, Elmhurst, NY 11373-4933 | 2008-06-06 |
| Find all providers in ELMHURST | ||||
Please comment or provide details below to improve the information on ICAHN SCHOOL OF MEDICINE AT MOUNT SINAI.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.