Individual provider Active NPI

Philip Roopchan Baldeo, MD

  • Family Medicine Physician
  • Richmond Hill, NY
National Provider Identifier
1003992033
Registry record updated Mar 15, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
194531 Issued in NY
Practice address
125-07 Liberty Avenue
Richmond Hill, NY 11419
Phone
(718) 845-8900
Fax
(866) 372-8750
NPI assigned
Oct 31, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 15, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 194531 NY Primary

Addresses

Primary practice location

125-07 Liberty Avenue
Richmond Hill, NY 11419

Mailing address

12507 Liberty Ave
South Richmond Hill, NY 11419-2233
Phone (718) 845-8900

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20111012000427 NY Practitioner - Family Practice 1456523646 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 1985
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

12507 Liberty Ave
South Richmond Hill, NY 11419-2233
Phone (718) 845-8900

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
194531NYMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Philip R Baldeo Medical Services PC Family Medicine Current Accepting new patients
125 Liberty Medical PLLC Family Medicine Current Accepting new patients
Daniel S. Berman, M.D., Infectious Diseases P.C. PastSince Apr 6, 2024 Accepting new patients

Locations

12507 Liberty Ave
South Richmond Hl, NY 11419
Phone (718) 845-8900

Networks

  • Healthfirst Medicare Network H9678
  • Healthfirst Medicare Network H3359
  • Healthfirst Medicare Network H1722
  • Healthfirst Medicare Network H5989

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1162252800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1678838400000",
    "number": "1003992033",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12507 LIBERTY AVE",
            "city": "SOUTH RICHMOND HILL",
            "state": "NY",
            "postal_code": "114192233",
            "telephone_number": "718-845-8900",
            "fax_number": "866-372-8750"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "125-07 LIBERTY AVENUE",
            "city": "RICHMOND HILL",
            "state": "NY",
            "postal_code": "11419",
            "telephone_number": "718-845-8900",
            "fax_number": "866-372-8750"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BALDEO",
        "first_name": "PHILIP",
        "middle_name": "ROOPCHAN",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-10-31",
        "last_updated": "2023-03-15",
        "certification_date": "2023-03-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NY",
            "license": "194531",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Richmond Hill, NY

Sources for this page

Verify at the official NPI Registry.