Medicare Provider Directory | April 2020 (Manhattan)
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2020 MetroPlus Medicare Directory Table of Contents General Introduction ...........................................................................................................5 Hospitals.............................................................................................................................23 Retail Health Clinics .........................................................................................................25 Urgent Care Centers ........................................................................................................27 FQHC (Federally Qualified Health Centers) .................................................................31 HIV Primary Care Facilities .............................................................................................35 HIV Primary Care and Substance Abuse Providers ....................................................39 Health Home / Psychosocial Support Services ...........................................................41 Primary Care Providers ....................................................................................................43 HIV Primary Care Providers ............................................................................................77 Participating Specialists ...................................................................................................81 Outpatient Mental Health Providers .............................................................................241 Outpatient Mental Health Organizations ......................................................................331 AIDS Adult Day Health Care Centers (for Medicaid members only) ..................................................................................................................................369 Audiology/Hearing ..........................................................................................................370 Certified Home Health Care ..........................................................................................371 Dialysis Centers ..............................................................................................................373 Durable Medical Equipment (DME) ..............................................................................377 Facility Based Occupational Therapy ..........................................................................390 Facility Based Physical Therapy ...................................................................................391 Facility Based Speech Therapy ....................................................................................392 Hospice Care ...................................................................................................................393 Laboratory ........................................................................................................................395 Orthotics and Prosthetics ...............................................................................................400 Radiology Services .........................................................................................................404 Skilled Nursing Facility (SNF) .......................................................................................409 Vision Care Services ......................................................................................................413 Chain Pharmacies ..........................................................................................................419 Retail Pharmacies ...........................................................................................................421 Mail Order Pharmacies ..................................................................................................435 Home Infusion Pharmacies ...........................................................................................437 Long Term Care Pharmacies ........................................................................................439 Provider Index .................................................................................................................441 160 Water Street, New York, NY 10038 1-866-986-0356 MetroPlus Health Plan HMO Plan Provider/Pharmacy Directory This directory is current as of 04/01/2020. This directory provides a list of MetroPlus Health Plan’s current network providers and pharmacies. This directory is for Manhattan. To access MetroPlus Health Plan’s online provider/pharmacy directory, you can visit www.metroplusmedicare.org. For any questions about the information contained in this directory, please call our Member Service Department at 1-866-986-035, 24 hours a day, 7 days a week. TTY users should call 711. MetroPlus Health Plan is an HMO, HMO SNP plan with a Medicare contract. Enrollment in MetroPlus Health Plan depends on contract renewal. Out-of-network/non- contracted providers are under no obligation to treat MetroPlus Health Plan members, except in emergency situations. Please call our customer service number or see your Evidence of Coverage for more information, including the cost- sharing that applies to out-of- network services. The provider network may change at any time. You will receive notice when necessary. H0423_MEM20_2283_C 09182019 5 Table of Contents Section 1 – Introduction .............................................................................................................. 7 What is the service area for MetroPlus Health Plan? ............................................................. 8 How do you find MetroPlus Health Plan providers that serve your area?.............................. 8 6 Section 1 – Introduction This directory provides a list of MetroPlus Health 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 listed in this directory to be your Primary Care Provider (PCP). Generally, you must get your health care services from your PCP. Your PCP can help you get care from other providers, such as specialists. Some services may require a referral. Please check your Evidence of Coverage for more information about how to access specific benefits. The network providers listed in this directory have agreed to provide you with your health care, vision, and dental services. You may go to any of our network providers listed in this directory; however, some services may require a referral. Talk to your PCP about getting a referral to another provider. If you have been going to one network provider, you are not required to continue to go to that same provider. In some cases, you may get covered services from non- network providers. Please see your Evidence of Coverage for more information. If a non-network provider sends you a bill directly, you should not pay that bill. Call MetroPlus Member Services, and we will explain how to submit the bill to us to determine how it should be paid. MetroPlus Health Plan does not cover care received outside of the service area except in case of an emergency. You may get covered emergency medical care wherever you need it, anywhere in the United States or its territories. 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 network providers except in emergency or urgent care situations. If you obtain routine care from out-of-network providers, neither Medicare nor MetroPlus Health Plan will be responsible for the costs. H0423_MEM20_2283_C 09182019 7 What is the service area for MetroPlus Health Plan? The counties in our service area are listed below. • Bronx • Kings (Brooklyn) • Queens • Richmond (Staten Island) • New York (Manhattan) How do you find MetroPlus Health Plan providers that serve your area? This directory lists the PCPs, specialists, pharmacies, hospitals and other providers that participate in the MetroPlus Health Plan network. Providers are listed in alphabetical order by specialty, by zip code. You can also use the MetroPlus Health Plan website, www.metroplusmedicare.org, to find a provider. On the website, go to the “Members” page and click on “Find A Doctor” to search for a physician, specialist, pharmacy, or hospital. You can search for a provider or pharmacy that meets your needs, such as one that has an office in or near a particular zip code that is convenient to you. If you have questions about MetroPlus Health Plan or require assistance in selecting a PCP, please call our Member Service Department at 1-866-986-0356, 24 hours, 7 days a week. TTY users should call 711. You can also visit www.metroplusmedicare.org. 8 MetroPlus Health Plan 2020 Provider/Pharmacy Directory This provider/pharmacy directory was updated on 04/01/2020. For more recent information or other questions, please contact MetroPlus Health Plan Member Services at 1-866-986-0356 or, for TTY users, 711, 24 hours a day, 7 days a week, or visit www.metroplusmedicare.org. Changes to our pharmacy network may occur during the benefit year. An updated Provider/Pharmacy Directory is located on our website at www.metroplusmedicare.org. You may also call Member Services for updated provider information. Introduction This booklet provides a list of MetroPlus Health