Organization Active NPI

Pinnacle Medical Services, PC

  • Internal Medicine Physician
  • New York, NY
National Provider Identifier
1023268265
Registry record updated Oct 22, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
213168 Issued in NY
Legal business name
PINNACLE MEDICAL SERVICES, PC
Practice address
615 W 173Rd St
Suite 1C
New York, NY 10032-1617
Phone
(212) 740-5555
NPI assigned
Sep 24, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 22, 2013

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

Authorized official

Name
Dr. Olugbenga Dawodu, MDNPI 1598890527
Title
Medical Director
Phone
(212) 740-5555

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
Internal Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207R00000X 213168 NY Primary

Addresses

Primary practice location

615 W 173Rd St
Suite 1C
New York, NY 10032-1617

Mailing address

40 Nassau Blvd
Garden City, NY 11530-4158
Phone (516) 812-5007

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20131127000528 NY Part B Supplier - Clinic/Group Practice 0143456921 Receives reassigned benefits from 1 practitioner
Practice locations: New York, NY

National Provider Directory

National Provider Directory

Locations

615 W 173rd St
New York, NY 10032

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/JGFFAA

Practitioners & affiliated clinicians

Practitioners 1

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

NPI Registry JSON

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

{
    "created_epoch": "1222214400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1382400000000",
    "number": "1023268265",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "40 NASSAU BLVD",
            "city": "GARDEN CITY",
            "state": "NY",
            "postal_code": "115304158",
            "telephone_number": "516-812-5007"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "615 W 173RD ST",
            "address_2": "SUITE 1C",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100321617",
            "telephone_number": "212-740-5555"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PINNACLE MEDICAL SERVICES, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-09-24",
        "last_updated": "2013-10-22",
        "status": "A",
        "authorized_official_last_name": "DAWODU",
        "authorized_official_first_name": "OLUGBENGA",
        "authorized_official_title_or_position": "MEDICAL DIRECTOR",
        "authorized_official_telephone_number": "212-740-5555",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine",
            "state": "NY",
            "license": "213168",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 22, 2013; 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.