MEDICARE: MOUNT KISCO MEDICAL GROUP PC

Medicare Provider Information

Scope of Practice

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

#	Taxonomy Code	Taxonomy
1	207KA0200X	Allergy Physician
2	207N00000X	Dermatology Physician
3	207RC0000X	Cardiovascular Disease Physician
4	207RE0101X	Endocrinology, Diabetes & Metabolism Physician
5	207RG0100X	Gastroenterology Physician
6	207RH0000X	Hematology (Internal Medicine) Physician
7	207VG0400X	Gynecology Physician
8	207XS0106X	Orthopaedic Hand Surgery Physician
9	207XX0004X	Orthopaedic Foot and Ankle Surgery Physician
10	2085R0202X	Diagnostic Radiology Physician
11	208600000X	Surgery Physician
12	208C00000X	Colon & Rectal Surgery Physician
13	231H00000X	Audiologist
14	367A00000X	Advanced Practice Midwife
15	207RH0003X	Hematology & Oncology Physician

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1982641619
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MOUNT KISCO MEDICAL GROUP PC

Provider Business Mailing Address
First Line	:	90 S BEDFORD RD
Second Line	:	MOUNT KISCO MEDICAL GROUP PC
City	:	MOUNT KISCO
State	:	NY
Zip	:	10549-3412
Country	:	US
Telephone Number	:	914-241-1050
Fax Number	:	914-242-1516

Provider Business Practice Location Address
First Line	:	185 ROUTE 312
Second Line	:	SOUTHEAST EXECUTIVE PARK MOUNT KISCO MEDICAL GROUP PC
City	:	BREWSTER
State	:	NY
Zip	:	10509-2338
Country	:	US
Telephone Number	:	845-278-7000
Fax Number	:	914-242-1516

Authorized Official
Title or Position	:	MEDICAL DIRECTOR
Name	:	ABE LEVY
Credential	:	MD
Telephone Number	:	914-242-1587

Provider Enumeration Date	:	06/01/2006
Last Update Date	:	09/11/2025

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Directions to “MOUNT KISCO MEDICAL GROUP PC ” Practice Location

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