NPIMap

Organization Active NPI

Excel Medical PC

  • Family Medicine Physician
  • Flushing, NY
National Provider Identifier
1003005083
Registry record updated Apr 10, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
244694 Issued in NY
Legal business name
EXCEL MEDICAL PC
Practice address
4348 Colden Street
Flushing, NY 11355
Phone
(718) 961-5060
Fax
(718) 961-5900
NPI assigned
Oct 16, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 10, 2008

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Dr. Mikhail B Pinkhasov, MDNPI 1427255439
Title
Medical Director
Phone
(718) 961-5060

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207Q00000X 244694 NY Primary

Addresses

Primary practice location

4348 Colden Street
Flushing, NY 11355

Mailing address

PO Box 520390
Flushing, NY 11352-0390
Phone (718) 755-0656

Other identifiers 1

IdentifierTypeStateIssuer
02889710MedicaidNY

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20071024000533 NY Part B Supplier - Clinic/Group Practice 4486741303 Receives reassigned benefits from 16 practitioners
Practice locations: Fresh Meadows, NY; Flushing, NY; Rego Park, NY; Jamaica, NY

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 36

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

View all 36

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1192492800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1207785600000",
    "number": "1003005083",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 520390",
            "city": "FLUSHING",
            "state": "NY",
            "postal_code": "113520390",
            "telephone_number": "718-755-0656",
            "fax_number": "718-961-5900"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4348 COLDEN STREET",
            "city": "FLUSHING",
            "state": "NY",
            "postal_code": "11355",
            "telephone_number": "718-961-5060",
            "fax_number": "718-961-5900"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EXCEL MEDICAL PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-10-16",
        "last_updated": "2008-04-10",
        "status": "A",
        "authorized_official_last_name": "PINKHASOV",
        "authorized_official_first_name": "MIKHAIL",
        "authorized_official_middle_name": "B",
        "authorized_official_title_or_position": "MEDICAL DIRECTOR",
        "authorized_official_telephone_number": "718-961-5060",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": "NY",
            "license": "244694",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02889710",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Flushing, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 10, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.