MEDICARE: TRUSTEES OF COLUMBIA UNIVERSITY IN THE CITY OF NEW YORK

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy
1	207XX0005X	Sports Medicine (Orthopaedic Surgery) Physician
2	207XX0801X	Orthopaedic Trauma Physician
3	207XS0114X	Adult Reconstructive Orthopaedic Surgery Physician
4	207X00000X	Orthopaedic Surgery Physician
5	207XP3100X	Pediatric Orthopaedic Surgery Physician
6	207XS0106X	Orthopaedic Hand Surgery Physician
7	207XS0117X	Orthopaedic Surgery of the Spine Physician
8	207XX0004X	Orthopaedic Foot and Ankle Surgery Physician
9	332B00000X	Durable Medical Equipment & Medical Supplies

General Provider Information

NPI Number	:	1215326814
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	TRUSTEES OF COLUMBIA UNIVERSITY IN THE CITY OF NEW YORK

Provider Business Mailing Address
First Line	:	400 KELBY ST
Second Line	:
City	:	FORT LEE
State	:	NJ
Zip	:	07024-2943
Country	:	US
Telephone Number	:	212-853-6414
Fax Number	:

Provider Business Practice Location Address
First Line	:	161 FORT WASHINGTON AVE
Second Line	:	2ND FLOOR
City	:	NEW YORK
State	:	NY
Zip	:	10032
Country	:	US
Telephone Number	:	212-305-5974
Fax Number	:

Authorized Official
Title or Position	:	CHIEF EXECUTIVE OFFICER
Name	:	DR. JAMES MICHAEL MCKIERNAN
Credential	:	MD
Telephone Number	:	212-305-5526

Provider Enumeration Date	:	01/20/2015
Last Update Date	:	03/18/2026

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Directions to “TRUSTEES OF COLUMBIA UNIVERSITY IN THE CITY OF NEW YORK ” Practice Location

Language	Start Address	Practice Location

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