ICAHN SCHOOL OF MEDICINE AT MOUNT SINAI (NPI# 1154813350) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1154813350 |
| Entity Type | Organization |
| Organization Name | ICAHN SCHOOL OF MEDICINE AT MOUNT SINAI |
| Other Organization Name | MOUNT SINAI DOCTORS SOUTH NASSAU - OB/GYN |
| Practice Address |
196 Merrick Rd Oceanside NY 11572 |
| Mailing Address |
1 Healthy Way Oceanside NY 11572-1551 |
| Practice Telephone | 5162558400 |
| Enumeration Date | 2018-06-04 |
| Last Update Date | 2018-06-16 |
| Authorized Official Name | ALICIA GRESHAM (VP OF NETWORK OPERATIONS) |
| Authorized Official Telephone | 2126599038 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 207Q00000X | Family Medicine | Allopathic & Osteopathic Physicians | ||
| N | 363A00000X | Physician Assistant | Physician Assistants & Advanced Practice Nursing Providers | ||
| N | 207VX0000X |
Obstetrics & Gynecology Specialization: Obstetrics |
Allopathic & Osteopathic Physicians | ||
| Y | 207V00000X | Obstetrics & Gynecology | Allopathic & Osteopathic Physicians |
| Other Name | Type Code |
|---|---|
| MOUNT SINAI DOCTORS SOUTH NASSAU - OB/GYN | Other Name - Individual/Organization |
| MOUNT SINAI DOCTORS SOUTH NASSAU-OB/GYN | Other Name - Individual/Organization |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 2965 Long Beach Rd, Oceanside, NY 115723255 | 5167637820 | |
| 1 Healthy Way, Oceanside, NY 115721551 | 8777688462 | |
| 2900 Hempstead Tpke Ste 203, Levittown, NY 117561401 | 5162273333 |
| 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 |
196 MERRICK RD |
| City | OCEANSIDE |
| State | NY |
| Zip Code | 11572 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1619962586 | Scott Ippolito | Family Medicine | 196 Merrick Rd, Oceanside, NY 11572-1420 | 2005-09-15 |
| 1053940718 | Cheyenne Kidder | Student in an Organized Health Care Education/Training Program | 196 Merrick Rd, Oceanside, NY 11572-1420 | 2020-04-05 |
| 1730717364 | Jason Pyon | Student in an Organized Health Care Education/Training Program | 196 Merrick Rd, Oceanside, NY 11572-1420 | 2020-03-30 |
| 1598393258 | Danielle Ferstler | Student in an Organized Health Care Education/Training Program | 196 Merrick Rd, Oceanside, NY 11572-1420 | 2020-03-30 |
| 1164059499 | Nancy Shilian | Student in an Organized Health Care Education/Training Program | 196 Merrick Rd, Oceanside, NY 11572-1420 | 2020-03-25 |
| 1013544592 | David Elliot Bernstein | Student in an Organized Health Care Education/Training Program | 196 Merrick Rd, Oceanside, NY 11572-1420 | 2020-03-25 |
| 1902369416 | Sol Silverman | Student in an Organized Health Care Education/Training Program | 196 Merrick Rd, Oceanside, NY 11572-1420 | 2019-04-11 |
| 1326500794 | Joshua Sae Jin Son | Student in an Organized Health Care Education/Training Program | 196 Merrick Rd, Oceanside, NY 11572-1420 | 2019-04-03 |
| 1306308168 | Michael Adam Raghunath | Student in an Organized Health Care Education/Training Program | 196 Merrick Rd, Oceanside, NY 11572-1420 | 2019-04-02 |
| 1740742766 | Persis Celina Puello | Student in an Organized Health Care Education/Training Program | 196 Merrick Rd, Oceanside, NY 11572-1420 | 2019-04-01 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1376152868 | True North Dialysis Center LLC | Clinic/Center | 3005 Long Beach Rd, Oceanside, NY 11572 | 2020-07-30 |
| 1508493560 | Mercedes Andreina Cardenas Pena | Student in an Organized Health Care Education/Training Program | 196 South Nassau, Oceanside, NY 11572 | 2020-03-26 |
| 1275170219 | Prohealth Dental Pllc | Dentist | 2870 Long Beach Road, Oceanside, NY 11572 | 2019-12-10 |
| 1982252409 | Fe Jaurigue | Nurse Practitioner | 2391 Washington Ave, Oceanside, NY 11572 | 2019-08-28 |
| 1689160749 | Emil A Tocci, Dc, PC | Chiropractor | 3091 Lawson Blvd, Oceanside, NY 11572 | 2018-07-02 |
| 1336652726 | Jennifer L Rodgers | Nurse Practitioner | 435 Kinsley Ct, Oceanside, NY 11572 | 2017-11-08 |
| 1205387859 | Joanne Hudkins | Nurse Practitioner | 3353 5th St, Oceanside, NY 11572 | 2016-10-19 |
| 1346693595 | Michelle Coletta-guadagno | Case Manager/Care Coordinator | 400 Oceanside Pkwy, Oceanside, NY 11572 | 2016-07-22 |
| 1831543271 | Costco Wholesale Corporation | Eyewear Supplier (Equipment, not the service) | 3705 Hampton Rd, Oceanside, NY 11572 | 2016-04-22 |
| 1598170474 | Amy Daleo | Licensed Practical Nurse | 299 Waukena Ave, Oceanside, NY 11572 | 2014-06-30 |
| Find all providers in zip 11572 | ||||
| Taxonomy Code | 207V00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Obstetrics & Gynecology |
| An obstetrician/gynecologist possesses special knowledge, skills and professional capability in the medical and surgical care of the female reproductive system and associated disorders. This physician serves as a consultant to other physicians and as a primary physician for women. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definiton added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Obstetrics and Gynecology, 2007. http://www.abog.org/. American Osteopathic Board of Obstetrics and Gynecology, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Obstetrics and Gynecology. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Obstetrics and Gynecology. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1952676041 | Ellen C. Mandell | Obstetrics & Gynecology | 4635 Waverly Rd, Oceanside, CA 92056-4914 | 2012-03-21 |
| 1093956328 | David A Halio Md PC | Obstetrics & Gynecology | 257 Foxhurst Rd, Oceanside, NY 11572-2352 | 2009-03-17 |
| 1700963386 | David Albert Halio | Obstetrics & Gynecology | 257 Foxhurst Road, Oceanside, NY 11572 | 2006-11-01 |
| 1851311617 | Vista Way Ob-gyn Medical Group, In.c. | Obstetrics & Gynecology | 3998 Vista Way Ste C202, Oceanside, CA 92056-4518 | 2006-07-21 |
| 1639170459 | Rahele Mazarei | Obstetrics & Gynecology | 3998 Vista Way Ste C, Oceanside, CA 92056-4514 | 2005-08-02 |
| 1477929974 | Talal R. Muhtaseb M.d. Inc | Obstetrics & Gynecology | 3998 Vista Way, Suite C, Oceanside, CA 92056 | 2015-08-19 |
| 1053718460 | Radiance Ob-gyn | Obstetrics & Gynecology | 3998 Vista Way, Suite C, Oceanside, CA 92056-4500 | 2014-12-01 |
| 1710399811 | Kristin Marie Osterman Desantis | Obstetrics & Gynecology | 200 Mercy Circle, Oceanside, CA 92055 | 2014-05-22 |
| 1619232642 | Deanna Young | Obstetrics & Gynecology | 4318 Mission Ave, Oceanside, CA 92057-6541 | 2012-07-05 |
| 1952664401 | Gabriel E Labbad | Obstetrics & Gynecology | 2210 Mesa Dr Ste 5, Oceanside, CA 92054-3701 | 2012-06-20 |
| Find all providers in OCEANSIDE | ||||
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| 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.