Medicare HMO netwOrk prOvider directOrY Bronx EMBLEMHEALTH MEDICARE HMO PLAN PROVIDER DIRECTORY This directory provides a list of EmblemHealth Medicare HMO’s network providers. This directory is for Bronx County. This directory is current as of August 2015. Some network providers may have been added or removed from our network after this directory was printed. We do not guarantee that each provider is still accepting new members. To get the most up-to-date information about EmblemHealth Medicare HMO’s network providers in your area, you can visit www.emblemhealth.com/medicare or call our Customer Service Department at 1-877-344-7364, Monday to Sunday, 8:00 am to 8:00 pm. TTY users should call 711. HIP Health Plan of New York (HIP) is an HMO plan with a Medicare contract. Enrollment in HIP depends on contract renewal. HIP is an EmblemHealth company. This information is available for free in other languages. Please contact our Customer Service number at 1-877-344-7364, Monday to Sunday, 8:00 am to 8:00 pm. TTY users should call 711. Esta información está disponible gratis en otros idiomas. Comuníquese con nuestro departamento se Servicio al cliente al 1-877-344-7364 para obtener mas informacion. (Los usuarios de TTY deben llamar al 711). This document may be available in alternate formats such as large print. Formulary, pharmacy network, and/or provider network may change at any time. You will receive notice when necessary. Y0026_126002 Accepted 08/26/2015 i EMBLEMHEALTH MEDICARE HMO NETWORK PROVIDER DIRECTORY Section 1 – Introduction This directory provides a list of our plan’s network providers. To get detailed information about your health care coverage, please see your Evidence of Coverage (EOC). You will have to choose one of our network providers who are listed in this directory to be your Primary Care Provider (PCP). The term “PCP” will be used throughout this directory. Generally, you must get your health care coverage from your PCP. Your PCP is your primary care provider who can provide and coordinate all of your care, including specialist visits, hospital admissions and more. The “network providers” listed in this directory have agreed to provide you with your health care and vision coverage. You may go to any of our network providers listed in this directory. However, some services may require a referral. If you have been going to one network provider, you are not required to continue going to that same provider. In some cases, you may get covered services from non-network providers. Please check your EOC for more details on specific referral requirements and more details about your plan benefits. There may be times when you get a bill from a provider for the full cost of medical care you have received. In many cases, you should send this bill to us instead of paying it. We will look at the bill and decide whether the services should be covered. If we decide they should be covered, we will pay the provider directly. You may get services from out-of-area providers when providers of specialized services are not available in the service area, including kidney dialysis services for End Stage Renal Disease enrollees who have traveled outside the plan’s service area or cannot access qualified dialysis providers within the service area You may also get services from out-of-area providers in situations where emergency or urgently needed care is needed. Our plan covers emergency and urgently needed care anywhere in the world. If you experience a medical emergency, call for help or go to the nearest emergency room or hospital. Call for an ambulance if you need it. You do not need to get approval or a referral first. After the emergency is over, you are entitled to follow-up care to be sure your condition continues to be stable. Your follow-up care will be covered by our plan. If your emergency care is provided by out-of-network providers, we will try to arrange for network providers to take over your care as soon as your medical condition and the circumstances allow. You must use plan providers except in emergency or urgent care situations or for out-of- area renal dialysis or other services. If you obtain routine care from out-of-network providers neither Medicare nor our plan will be responsible for the costs. ii EMBLEMHEALTH MEDICARE HMO NETWORK PROVIDER DIRECTORY What is the service area for EmblemHealth Medicare HMO? The counties in our service area are listed below: Bronx, Kings, New York, Queens, Richmond, Nassau, Suffolk and Westchester How do you find EmblemHealth Medicare HMO providers in your area? You can find a network provider by looking in this directory or going online at www.emblemhealth.com/medicare. We do everything possible to keep our directories current, but participation status can change from time to time. Before selecting your provider, you may want to confirm that he or she is still participating in the plan’s network and with the product you are covered by, and if he or she is accepting new patients. You can do this by contacting the provider at the phone number listed in the directory. If you have questions about our plan or require assistance in selecting a PCP, please call our Customer Service Department at 1-877-344-7364, Monday to Sunday, 8:00 am to 8:00 pm. TTY users should call 711. Or visit www.emblemhealth.com/medicare. iii EMBLEMHEALTH VENDORS The vendors listed below are partners with EmblemHealth and provide certain services on our behalf. ValueOptions The names of the providers listed and the information about them are furnished and managed by ValueOptions, which has a contract with EmblemHealth. This allows you to find a ValueOptions provider as part of your in-network benefit. The accuracy of these listings is confirmed annually by ValueOptions. Comprehensive Professional Systems, General Vision Services and Eyecare Advantage The names of the providers listed and the information about them are furnished and managed by Comprehensive Professional Systems, General Vision Services and Eyecare Advantage, which have contracts with EmblemHealth. This allows you to find Comprehensive Professional Systems, General Vision Services and Eyecare Advantage provider services as part of your in-network benefit. The accuracy of these listings is confirmed annually by Comprehensive Professional Systems, General Vision Services and Eyecare Advantage. Express Scripts, Inc. (ESI) The names of the providers listed and the information about them are furnished and managed by ESI, which has a contract with EmblemHealth. This allows you to find an ESI provider as part of your in-network benefit. The accuracy of these listings is confirmed annually by ESI. Y0026_ 24657 Accepted 09/01/2014 v EMBLEMHEALTH MEDICARE HMO PROVIDER DIRECTORY - BRONX HOSPITAL ABBREVIATION KEY .............................................................................. 1 PRIMARY CARE PHYSICIANS ................................................................................... 5 Bronx ............................................................................................................................... 7 SPECIALTY CARE PHYSICIANS ............................................................................ 55 Bronx ............................................................................................................................ 57 EMBLEM BEHAVIORAL HEALTH SERVICES PROGRAM ....................... 413 Behavioral Health Facilities ............................................................................. 415 Outpatient Behavioral Health Specialists ................................................ 434 SKILLED NURSING FACILITIES .......................................................................... 447 HOSPITALS .................................................................................................................... 451 IMMEDIATE AND URGENT CARE CENTERS ............................................... 463 OPTICAL PROVIDERS ............................................................................................. 469 Bronx .......................................................................................................................... 471 DESIGNATED AIDS CENTERS (DACs) AND EXPERIENCED AIDS PROVIDERS .................................................................................................................. 475 COMMUNITY HEALTH CARE CENTERS ......................................................... 491 QUEST DIAGNOSTICS LABS ............................................................................... 499 ANCILLARY PROVIDERS ...................................................................................... 503 INDEX OF HOSPITALS ............................................................................................. 513 INDEX BY LAST NAME ............................................................................................. 517