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NPI 1558058404ActiveIndividual· Family Medicine· Bronx, NY

Family Medicine in Bronx, New York, licensed in NY, with an NPI issued in April 2023. Part D covered 36 prescriptions written in 2024, 92% of them generic.

Overview

NPI1558058404
StatusActive
Entity typeIndividual
Sole proprietorNo
NPI issuedApr 20, 2023
Last updated in NPPESAug 18, 2026
Certified by providerAug 18, 2026

Specialties and licenses

TaxonomyCodeLicenseState
Family Medicine Primary207Q00000X346397NY

About license numbers in NPPES

Exclusion screening

ListResultDetails
HHS-OIG LEIE · Oct 9, 2026No matchChecked by NPI and by name + state
North Carolina Medicaid · Nov 4, 2026No match—
New York OMIG · Nov 4, 2026No match—
Ohio Medicaid · Nov 4, 2026No match—
Pennsylvania Medicheck · Nov 4, 2026No match—
Washington HCA · Nov 4, 2026No match—

Official OIG search · How matching works ·Bulk check a roster

Medicare

Enrollment (PECOS)Not in the public enrollment file of Oct 1, 2026

Part D prescriptions in 2024

Prescriptions (claims)36 · 48 30-day fills
Patients14
Total drug cost$1,598
Generic share92% of claims

Medicare sources and data years

Industry payments (Open Payments)

None reported for 2025 or 2024.

Receiving payments does not imply wrongdoing. What Open Payments covers ·original records

Other Family Medicine providers in Bronx

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