ICAHN SCHOOL OF MEDICINE AT MOUNT SINAI (NPI# 1942792304) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1942792304 |
| Entity Type | Organization |
| Organization Name | ICAHN SCHOOL OF MEDICINE AT MOUNT SINAI |
| Other Organization Name | MOUNT SINAI DOCTORS SOUTH NASSAU - INTERNAL/FAMILY MEDICINE |
| Practice Address |
196 Merrick Rd Oceanside NY 11572 |
| Mailing Address |
1 Healthy Way Oceanside NY 11572-1551 |
| Practice Telephone | 5162558400 |
| Enumeration Date | 2018-06-01 |
| 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 | 207QB0002X |
Family Medicine Specialization: Obesity Medicine |
Allopathic & Osteopathic Physicians | ||
| N | 207QG0300X |
Family Medicine Specialization: Geriatric Medicine |
Allopathic & Osteopathic Physicians | ||
| N | 207RC0000X |
Internal Medicine Specialization: Cardiovascular Disease |
Allopathic & Osteopathic Physicians | ||
| N | 207RI0200X |
Internal Medicine Specialization: Infectious Disease |
Allopathic & Osteopathic Physicians | ||
| N | 363A00000X | Physician Assistant | Physician Assistants & Advanced Practice Nursing Providers | ||
| N | 363L00000X | Nurse Practitioner | Physician Assistants & Advanced Practice Nursing Providers | ||
| N | 363LA2200X |
Nurse Practitioner Specialization: Adult Health |
Physician Assistants & Advanced Practice Nursing Providers | ||
| Y | 207R00000X | Internal Medicine | Allopathic & Osteopathic Physicians |
| Other Name | Type Code |
|---|---|
| MOUNT SINAI DOCTORS SOUTH NASSAU - INTERNAL /FAMILY MEDICINE | Other Name - Individual/Organization |
| MOUNT SINAI DOCTORS SOUTH NASSAU - INTERNAL/FAMILY MEDICINE | Other Name - Individual/Organization |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 1 Healthy Way, Oceanside, NY 115721551 | 8777688462 | |
| 1 S Central Ave, Valley Stream, NY 115805443 | 5167637820 | |
| 1420 Broadway, Hewlett, NY 115571321 | 5163748631 | |
| 1436 Broadway, Hewlett, NY 115571405 | 5164977422 | |
| 155 W Merrick Rd, Freeport, NY 115203743 | 5163793139 | |
| 185 Merrick Rd Ste B, Lynbrook, NY 115632700 | 5168870077 | |
| 2280 Grand Ave Ste 208, Baldwin, NY 115103110 | 5166234800 | |
| 250 Fulton Ave Fl 1, Hempstead, NY 115503917 | 8777688462 | |
| 2750 Merrick Rd, Bellmore, NY 117105720 | 5164092000 | |
| 2965 Long Beach Rd, Oceanside, NY 115723255 | 5165938953 | |
| 325 W Park Ave, Long Beach, NY 115613223 | 5164324154 | |
| 761 Franklin Blvd, Long Beach, NY 115612450 | 5165442351 |
| 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 | 207R00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Internal Medicine |
| A physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults and the elderly. Internists are trained in the diagnosis and treatment of cancer, infections and diseases affecting the heart, blood, kidneys, joints and digestive, respiratory and vascular systems. They are also trained in the essentials of primary care internal medicine, which incorporates an understanding of disease prevention, wellness, substance abuse, mental health and effective treatment of common problems of the eyes, ears, skin, nervous system and reproductive organs. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source; 7/1/2011: modified source] - Additional Resources: American Board of Internal Medicine, 2007. http://www.abim.org/. American Osteopathic Board of Internal Medicine, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Internal Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Internal Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1265871693 | Emory Smith Winship Viii | Internal Medicine | Naval Hospital Camp Pendleton Internal Medicine Clinic, 200 Mercy Circle, Oceanside, CA 92055 | 2013-06-19 |
| 1790035673 | Robert Eli Resnick | Internal Medicine | 35 Patten Ave, Oceanside, NY 11572-1025 | 2012-09-18 |
| 1922234004 | Sanaa Saher Mithaiwala | Internal Medicine | 3091 Nassau Rd, Oceanside, NY 11572-3000 | 2009-06-03 |
| 1518100148 | Ryan Alan Smith | Internal Medicine | 3998 Vista Way Ste 200, Oceanside, CA 92056-4519 | 2009-04-13 |
| 1558500777 | Nagi Ibrahim Md Inc | Internal Medicine | 2122 S El Camino Real Ste 102, Suite B, Oceanside, CA 92054-6209 | 2009-02-11 |
| 1235314907 | Heather Lewis | Internal Medicine | 222 Cottonwood St N, Oceanside, CA 92058-6641 | 2007-12-31 |
| 1073705695 | Mes Medical Consultingpc | Internal Medicine | 97 Elaine Dr, Oceanside, NY 11572-5708 | 2007-08-16 |
| 1225126600 | Anitha Rajamanickam | Internal Medicine | 3230 Waring Ct Ste O, Oceanside, CA 92056-4509 | 2006-10-10 |
| 1437252665 | Glenn John Macdonald | Internal Medicine | 26 Davison Ave, Oceanside, NY 11572-2237 | 2006-09-06 |
| 1407871817 | Denise Gomez | Internal Medicine | 605 Crouch St Bldg C, Oceanside, CA 92054-4415 | 2006-07-13 |
| 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.