MEDICAL ASSOCIATE OF WALL STREET, P.C.
NPI 1912272592
Clinic/Center - Multi-Specialty in New York, NY
About Medical Associate Of Wall Street, P.c. NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
MEDICAL ASSOCIATE OF WALL STREET, P.C. (NPI 1912272592) is a healthcare organization registered as a multi-specialty in New York, New York and active in the NPI registry since March 2012. The organization holds a CLIA Waiver certificate valid through March 26, 2027 and lists Glenn Gandelman, Chief Executive Officer, as its authorized official.
NPPES Registry Identity
Specialties & Licenses 3
Group Practice 1
Medicare Participation & PECOS CMS
Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.
Medicare Enrollment Status
Enrolled in Medicare (PECOS)
Medical Associate Of Wall Street, P.c. is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Clinicians Billing Medicare Through This Organization
12Medicare enrollment records show 12 clinicians reassign Medicare billing to Medical Associate Of Wall Street, P.C., which bills Medicare for the services they deliver. Of these, 1 practice at this address and 5 within 10 miles. They are listed nearest first.
Clinicians by Medicare Specialty 3
Clinicians, nearest first (12)
3 Fl, NY 11229
Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
CLIA Laboratory Certificates CMS CLIA
Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.
Certificate of Waiver 33D2086224
Medical Associates Of Wall Street PC · New York, NYFrequently 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 Medical Associate Of Wall Street, P.C.'s NPI number?
The NPI number for Medical Associate Of Wall Street, P.C. is 1912272592. It was assigned to this organization in the NPPES registry on March 15, 2012.
Where is Medical Associate Of Wall Street, P.C. located?
Medical Associate Of Wall Street, P.C. is located at 6 Maiden Ln Rm 500, New York, NY 10038. The listed phone number is (212) 233-3040.
What is Medical Associate Of Wall Street, P.C.'s specialty?
The primary specialty registered for this NPI is Clinic/Center, specializing in Multi-Specialty, with taxonomy code 261QM1300X.
Is Medical Associate Of Wall Street, P.C. enrolled in Medicare?
Yes. Medical Associate Of Wall Street, P.C. is registered in the Medicare PECOS enrollment system.
How many clinicians bill Medicare through Medical Associate Of Wall Street, P.C.?
According to the CMS Revalidation Reassignment List (October 2026 release), 12 clinicians in 3 Medicare specialties reassign their Medicare billing to Medical Associate Of Wall Street, P.C.. 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. The largest specialties are Nurse Practitioner (10), Cardiovascular Disease (Cardiology) (1) and Diagnostic Radiology (1). Of these, 1 practice at this address and 5 within 10 miles. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
Does Medical Associate Of Wall Street, P.C. hold a CLIA laboratory certificate?
Yes. A Certificate of Waiver (number 33D2086224) is associated with this NPI, valid through March 26, 2027. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.
When was this NPI record last updated?
The NPPES record for Medical Associate Of Wall Street, P.C. was last updated on September 20, 2022. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 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.
# Medical Associate Of Wall Street, P.c. · NPI 1912272592
Multi-Specialty organization in New York, New York. Organization record, active in the CMS NPPES registry since March 15, 2012.
## Identity
- **NPI:** 1912272592 (Entity type: Organization)
- **Enumerated:** March 15, 2012
- **Primary specialty:** Clinic/Center - Multi-Specialty · taxonomy 261QM1300X
- **Organization subpart:** No
- **Authorized official:** Glenn Gandelman, CHIEF EXECUTIVE OFFICER
## Practice location
- **Address:** 6 MAIDEN LN RM 500, New York, NY 10038-5140
- **Phone:** (212) 233-3040 · **Fax:** (212) 349-7529
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Clinicians billing through this organization:** 12 clinicians in 3 Medicare specialties reassign Medicare billing to this organization (form CMS-855R); largest: Nurse Practitioner (10), Cardiovascular Disease (Cardiology) (1), Diagnostic Radiology (1); 1 practice at this address and 5 within 10 miles · CMS Revalidation Reassignment List, October 2026 release
## Record status
- **NPPES last updated:** September 20, 2022
- **CLIA laboratory certificates:** 1 on file
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Source: [NPI Profile](https://npiprofile.com/npi/1912272592) · Data from the CMS NPPES public registry.