NPIMap

Organization Active NPI

Newyork-Presbyterian/Queens

  • Cardiovascular Disease Physician
  • Flushing, NY
National Provider Identifier
1013960962
Registry record updated Aug 14, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Cardiovascular Disease PhysicianTaxonomy code 207RC0000X
Legal business name
NEWYORK-PRESBYTERIAN/QUEENS
Practice address
5645 Main St
Flushing, NY 11355-5045
Phone
(718) 886-7014
Fax
(516) 437-4167
NPI assigned
May 19, 2006
Last updated
Aug 14, 2015By the provider in NPPES
Organization subpart
Yes
Parent organization
NEWYORK-PRESBYTERIAN/QUEENSAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Aug 14, 2015

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

Authorized official

Name
Ms. Dora Hartofilis
Title
Acting Director of Billing
Phone
(718) 661-8711

Specialties & licenses 15

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X NU
Registered Dietitian 133V00000X NU
Emergency Medicine Physician 207P00000X NU
Family Medicine Physician 207Q00000X NU
Cardiovascular Disease Physician 207RC0000X NU Primary
Obstetrics & Gynecology Physician 207V00000X NU
Ophthalmology Physician 207W00000X NU
Orthopaedic Surgery Physician 207X00000X NU
Anatomic Pathology & Clinical Pathology Physician 207ZP0102X NU
Pediatrics Physician 208000000X NU
Neurology Physician 2084N0400X NU
Psychiatry Physician 2084P0800X NU
Surgery Physician 208600000X NU
Podiatrist 213E00000X NU
Speech-Language Pathologist 235Z00000X NU

Addresses

Primary practice location

5645 Main St
Flushing, NY 11355-5045

Mailing address

PO Box 27842
New York, NY 10087-7842
Phone (718) 670-1651

Other identifiers 1

IdentifierTypeStateIssuer
02993566MedicaidNY

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040329000273 NY Part B Supplier - Clinic/Group Practice 7315839933 Receives reassigned benefits from 161 practitioners
Practice locations: New York, NY; Mineola, NY; Jamaica, NY; Jackson HTS, NY; Jackson HGTS, NY; Jackson Heights, NY; Hollis, NY; Fresh Meadows, NY…

Other NPIs with the same Medicare PAC ID 4

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

National Provider Directory

National Provider Directory
Part of
Nyhmcq Surgical PA

Locations

1600 Central Ave
Ste 303
Far Rockaway, NY 11691
Phone (718) 868-8645

18904 Hillside Ave
Hollis, NY 11423
Phone (718) 670-1884

7315 Northern Blvd
Jackson Hts, NY 11372
Phone (718) 424-2788

Practitioners & affiliated clinicians

Practitioners 297

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 297

NPI Registry JSON

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

{
    "created_epoch": "1147996800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1439510400000",
    "number": "1013960962",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 27842",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100877842",
            "telephone_number": "718-670-1651",
            "fax_number": "516-437-4167"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5645 MAIN ST",
            "city": "FLUSHING",
            "state": "NY",
            "postal_code": "113555045",
            "telephone_number": "718-886-7014",
            "fax_number": "516-437-4167"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NEWYORK-PRESBYTERIAN/QUEENS",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "NEWYORK-PRESBYTERIAN/QUEENS",
        "enumeration_date": "2006-05-19",
        "last_updated": "2015-08-14",
        "status": "A",
        "authorized_official_last_name": "HARTOFILIS",
        "authorized_official_first_name": "DORA",
        "authorized_official_title_or_position": "ACTING DIRECTOR OF BILLING",
        "authorized_official_telephone_number": "718-661-8711",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "207X00000X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "207ZP0102X",
            "taxonomy_group": "",
            "desc": "Pathology, Anatomic Pathology & Clinical Pathology",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "2084N0400X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "213E00000X",
            "taxonomy_group": "",
            "desc": "Podiatrist",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02993566",
            "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 Aug 14, 2015; 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.