MOUNT SINAI MARATHON MEDICAL
NPI 1508127531
Internal Medicine in Oceanside, NY

Q: What is the provider's specialty?

The provider's specialty is Internal Medicine with taxonomy code 207R00000X.

Active since June 06, 2012CLIA 33D2111232 · Microscopy

1 HEALTHY WAY, OCEANSIDE, NY 11572(516) 632-3670(516) 336-5309 Get Directions Write a Review

NPPES record last updated: October 24, 2018. Verified against the NPPES registry weekly; last sync: July 19, 2026.

Table of Contents

NPI Profile Information
Primary Taxonomy
Secondary Taxonomies
Group Taxonomy
Secondary Locations
Authorized Official
CLIA Information
Other Providers Same Location
Frequently Asked Questions

Organization
Internal Medicine
CLIA Number: 33D2111232
CLIA Cert. Type: Physician Office
CLIA Exp. Date: 03-26-2027

About MOUNT SINAI MARATHON MEDICAL

This page provides the complete NPI Profile along with additional information for Mount Sinai Marathon Medical, an internist established in Oceanside, New York operating as a Internal Medicine. The healthcare provider is registered in the NPI registry with number 1508127531 assigned on June 2012. The practitioner's primary taxonomy code is 207R00000X. The provider is registered as an organization and their NPI record was last updated 8 years ago. Mount Sinai Marathon Medical operates as a Multi-Specialty Group with one or more individual practitioners, who practice different areas of specialization. The provider's is doing business as Mount Sinai Marathon Medical. The authorized official of this NPI record is Alicia Gresham (Vp Network Operations)

NPI: 1508127531 Verify this NPI
Provider Legal Name: MOUNT SINAI SCHOOL OF MEDICINE
Other Organization Name: MOUNT SINAI MARATHON MEDICAL
Other Name Type: Doing Business As (3)
Entity Type: Organization
Location Address: 1 HEALTHY WAY OCEANSIDE, NY 11572
Location Phone: (516) 632-3670
Location Fax: (516) 336-5309
Mailing Address: 1 HEALTHY WAY OCEANSIDE, NY 11572
Mailing Phone: (516) 632-3670
Mailing Fax: (516) 336-5309
Is Sole Proprietor?: No
Is Organization Subpart?: Yes
Enumeration Date: 06-06-2012
Last Update Date: 10-24-2018
Code Navigator

An internist like Mount Sinai Marathon Medical is a physician who has completed an internal medicine residency and is board-certified or board-eligible in an internist specialty. Internists are trained to care for adults of all ages for many different medical conditions. An internist typically monitors chronic physical conditions, identifies acute diseases, provides family planning, provides counseling about wellness and disease prevention, etc.

Location Map

Secondary Locations

35 E 85th St SUITE S1 & S2
New York, NY 10028
(212) 426-7300

Specialty - Primary Taxonomy

The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.

Classification: Internal Medicine
Taxonomy Code: 207R00000X
Type: Allopathic & Osteopathic Physicians
Taxonomy Description: 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.

Secondary Taxonomies

The provider has reported to the NPI enumerator additional taxonomy codes. Multiple taxonomy codes may represent subspecialties or other areas of specialization the provider maybe licensed to practice.

No.	Taxonomy Code	Type	Classification / Specialization	License No. (State)
1	207RB0002X	Allopathic & Osteopathic Physicians	Internal Medicine Obesity Medicine

Group Taxonomy 193200000X MULTI-SPECIALTY GROUP

This provider is a business group of one or more individual practitioners, who practice with different areas of specialization.

Authorized Official

The authorized official is the designated individual with the legal authority to make changes to the provider’s official NPI record. For organizations, the authorized official must be a general partner, chairman of the board, CEO, CFO or a direct owner holding at least a 5 percent stake in the medical organization.

Authorized Official Name: ALICIA GRESHAM
Authorized Official Title: VP NETWORK OPERATIONS
Authorized Official Phone: (212) 659-9038

CLIA Information

The Clinical Laboratory Improvement Amendments (CLIA) of 1988 applies to facilities or sites that test human specimens for health assessment or to diagnose, prevent, or treat disease. The CLIA Program sets standards for clinical laboratory testing and issues certificates. The NPI / CLIA crosswalk information for this NPI number is:

CLIA Number: 33D2111232
Facility Type: Physician Office
Certificate Effective Date: April 01, 2026
Certificate Expiration Date: March 26, 2027
Laboratory Director: DR. BRUCE PETERSON
Certificate Type: Certificate for Provider-Performed Microscopy Procedures (PPMP)
Certificate Type Description: This CLIA certificate is issued to Mount Sinai Marathon Medical in which a physician, midlevel practitioner or dentist that performs specific microscopy procedures during the course of a patient's visit. A limited list of provider-performed microscopy procedures is included under this certificate type, which are categorized as moderate complexity testing.