ICAHN SCHOOL OF MEDICINE AT MOUNT SINAI (NPI# 1437641636) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1437641636 |
| Entity Type | Organization |
| Organization Name | ICAHN SCHOOL OF MEDICINE AT MOUNT SINAI |
| Other Organization Name | MOUNT SINAI DOCTORS SOUTH NASSAU - NEONATES / PEDIATRICS |
| 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 | 2080P0202X |
Pediatrics Specialization: Pediatric Cardiology |
Allopathic & Osteopathic Physicians | ||
| Y | 208000000X | Pediatrics | Allopathic & Osteopathic Physicians |
| Other Name | Type Code |
|---|---|
| MOUNT SINAI DOCTORS SOUTH NASSAU - NEONATES / PEDIATRICS | Other Name - Individual/Organization |
| MOUNT SINAI DOCTORS SOUTH NASSAU - NEONATES/PEDIATRICS | Other Name - Individual/Organization |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 1 Healthy Way, Oceanside, NY 115721551 | 5162558400 |
| 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 | 208000000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Pediatrics |
| A pediatrician is concerned with the physical, emotional and social health of children from birth to young adulthood. Care encompasses a broad spectrum of health services ranging from preventive healthcare to the diagnosis and treatment of acute and chronic diseases. A pediatrician deals with biological, social and environmental influences on the developing child, and with the impact of disease and dysfunction on development. |
| 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 Pediatrics, 2007. http://www.abp.org/. American Osteopathic Board of Pediatrics, 2007. http://www.osteopathic.org/certificatio - Board certification for Medical Doctors (MDs) is provided by the American Board of Pediatrics. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Pediatrics. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1912310020 | Erin Ramirez | Pediatrics | 3605 Vista Way Ste 130, Oceanside, CA 92056-4565 | 2014-06-05 |
| 1588969703 | N. Keri D.d.s. Apc | Pediatrics | 3625 Vista Way, Oceanside, CA 92055 | 2011-01-19 |
| 1699780049 | Jennifer Dolby | Pediatrics | 2210 Mesa Dr, Suite 12, Oceanside, CA 92054-3756 | 2006-07-31 |
| 1912921479 | Pamela Anne Wells | Pediatrics | 3230 Waring Ct Ste P, Oceanside, CA 92056-4509 | 2006-07-27 |
| 1104846567 | Lucila Karol Moreira | Pediatrics | 3605 Vista Way Bldg B, Oceanside, CA 92056-4565 | 2006-07-20 |
| 1033154984 | Bernard Wosk | Pediatrics | 4700 N River Rd, Oceanside, CA 92057-6043 | 2006-06-17 |
| 1619949443 | Anna E Lee | Pediatrics | 3230 Waring Ct, Ste J, Oceanside, CA 92056-4509 | 2006-02-06 |
| 1982689147 | Jesus Velasquez Mallari | Pediatrics | 5483 Papagallo Dr, Oceanside, CA 92057-1907 | 2005-12-09 |
| 1013371004 | Tina Udhwani Fallon | Pediatrics | 2210 Mesa Dr Ste 300, Oceanside, CA 92054 | 2016-04-06 |
| 1467833467 | Melissa S. Kramer | Pediatrics | 3605 Vista Way Bldg B, Oceanside, CA 92056 | 2015-06-15 |
| 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.