Individual provider Active NPI

Dhruv Mahendra Amin, DO

  • Internal Medicine Physician
  • Queens Village, NY
National Provider Identifier
1043520398
Registry record updated Oct 31, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
262347-1 Issued in NY
Practice address
21814 Hillside Ave
Queens Village, NY 11427-1951
Phone
(718) 776-4444
Fax
(718) 776-8536
NPI assigned
Oct 19, 2010
Last updated
Oct 31, 2019By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 31, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 262347-1 NY Primary

Addresses

Primary practice location

21814 Hillside Ave
Queens Village, NY 11427-1951

Mailing address

20 Turf LN
Roslyn Heights, NY 11577-2700
Phone (516) 395-1625

Other practice location 1

8902 Springfield Blvd
Queens Village, NY 11427-2514
Phone (718) 776-4444

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
I20131010000009 NY Practitioner - Internal MedicinePractitioner - Osteopathic Manipulative Medicine 4183858939 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal MedicineAlso: Osteopathic Manipulative Medicine
Education
New York College of Osteo Medicine of New York Institute of Technology, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Springfield Primary Care PCGroup PAC ID 0840424685, 2 clinicians

Practice addresses (Care Compare)

21814 Hillside Ave
Queens Village, NY 11427-1951
Phone (718) 776-4444

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
262347-1NYMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Springfield Primary Care, PC Internal Medicine CurrentSince Mar 27, 2013 Accepting new patients

Locations

21814 Hillside Ave
Queens Vlg, NY 11427
Phone (718) 776-4444

8902 Springfield Blvd
Queens Vlg, NY 11427
Phone (718) 776-4444

Networks

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

Interoperability endpoints

  • Direct secure messaging: dhruv.amin@springfieldprimcare.ehi.direct-ci.com

Organizations & group practices 1

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

NPI Registry JSON

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

{
    "created_epoch": "1287446400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1572480000000",
    "number": "1043520398",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "20 TURF LN",
            "city": "ROSLYN HEIGHTS",
            "state": "NY",
            "postal_code": "115772700",
            "telephone_number": "516-395-1625"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "21814 HILLSIDE AVE",
            "city": "QUEENS VILLAGE",
            "state": "NY",
            "postal_code": "114271951",
            "telephone_number": "718-776-4444",
            "fax_number": "718-776-8536"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "8902 Springfield Blvd",
            "address_purpose": "LOCATION",
            "city": "Queens Village",
            "state": "NY",
            "postal_code": "114272514",
            "country_code": "US",
            "telephone_number": "718-776-4444",
            "fax_number": "718-776-8536",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "AMIN",
        "first_name": "DHRUV",
        "middle_name": "MAHENDRA",
        "credential": "DO",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2010-10-19",
        "last_updated": "2019-10-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NY",
            "license": "262347-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Queens Village, NY

Sources for this page

Verify at the official NPI Registry.