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EXCELSIOR INTEGRATED MEDICAL GROUP, PLLC
NPI 1689009854
Specialist in New York, NY

Active since September 06, 2013
217 GRAND ST, SUITE 401, NEW YORK, NY 10013(212) 390-1830(212) 390-8177 Get Directions Write a Review

NPPES record last updated: February 3, 2016. Verified against the NPPES registry weekly; last sync: November 01, 2026.

About Excelsior Integrated Medical Group, Pllc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

EXCELSIOR INTEGRATED MEDICAL GROUP, PLLC (NPI 1689009854) is a healthcare organization registered as a specialist in New York, New York and active in the NPI registry since September 2013. The organization lists George Hall, President, as its authorized official.

NPPES Registry Identity

NPI1689009854
Entity TypeOrganization
Primary Taxonomy174400000X
Legal Business NameEXCELSIOR INTEGRATED MEDICAL GROUP, PLLC
Location Address217 GRAND ST, SUITE 401New York, NY 10013-4396
Mailing Address217 Grand St, Suite 401New York, NY 10013-4396 · (212) 390-1830 · Fax (212) 390-8177
Phone(212) 390-1830
Fax(212) 390-8177
Organization SubpartNo
Authorized OfficialGeorge HallPresident · (212) 335-0328
Enumeration DateSeptember 6, 2013
Last NPPES UpdateFebruary 3, 2016
✔ NPI 1689009854 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtySpecialistOther Service Providers
Taxonomy Code174400000X
License✔ Licensed in NY · 203601
Definition
An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree.
217 GRAND ST, New York, NY 10013
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Group Practice 1

Group TaxonomyThis provider is a business group of one or more individual practitioners, who practice with different areas of specialization.193200000X MULTI-SPECIALTY GROUP

Medicare Participation & PECOS CMS

Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Excelsior Integrated Medical Group, Pllc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Clinicians Billing Medicare Through This Organization

2

Medicare enrollment records show 2 clinicians reassign Medicare billing to Excelsior Integrated Medical Group, PLLC, which bills Medicare for the services they deliver. Of these, 2 practice within 10 miles. They are listed nearest first.

Clinicians, nearest first (2)

Simon Zaw Moe Thein, M.B.,B.S.
Cardiovascular Disease (Cardiology)
NPI 1740501055
762 59TH ST FL 1
Brooklyn, NY 11220
(718) 393-5333
✔ PECOS✔ Accepts Medicare5.7 mi
Howard Xu, FNP
Nurse Practitioner
NPI 1609341890
4266 KISSENA BLVD
Flushing, NY 11355
(917) 285-2780
✔ PECOS✔ Accepts Medicare9.3 mi

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Excelsior Integrated Medical Group, PLLC's NPI number?

The NPI number for Excelsior Integrated Medical Group, PLLC is 1689009854. It was assigned to this organization in the NPPES registry on September 6, 2013.

Where is Excelsior Integrated Medical Group, PLLC located?

Excelsior Integrated Medical Group, PLLC is located at 217 Grand St Suite 401, New York, NY 10013. The listed phone number is (212) 390-1830.

What is Excelsior Integrated Medical Group, PLLC's specialty?

The primary specialty registered for this NPI is Specialist with taxonomy code 174400000X.

Is Excelsior Integrated Medical Group, PLLC enrolled in Medicare?

Yes. Excelsior Integrated Medical Group, PLLC is registered in the Medicare PECOS enrollment system.

How many clinicians bill Medicare through Excelsior Integrated Medical Group, PLLC?

According to the CMS Revalidation Reassignment List (October 2026 release), 2 clinicians reassign their Medicare billing to Excelsior Integrated Medical Group, PLLC, in Cardiovascular Disease (Cardiology) and Nurse Practitioner. A reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for the clinician's services. Of these, 2 practice within 10 miles. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

When was this NPI record last updated?

The NPPES record for Excelsior Integrated Medical Group, PLLC was last updated on February 3, 2016. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 10 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.