Active NPI
Michael C Crismali, MD
- Family Medicine Physician
- Forest Hills, NY
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- License
- 1573881
- Practice address
- 11835 Queens Blvd Ste 400
Forest Hills, NY 11375-7211 - Phone
- (646) 722-7610
- NPI assigned
- Jul 18, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | 1573881 | NY | Primary |
Addresses
Primary practice location
11835 Queens Blvd Ste 400
Forest Hills, NY 11375-7211
Mailing address
PO Box 639295
Cincinnati, OH 45263-9295
Phone (248) 266-4200
Other practice location 1
1000 Church Ave
Flatbush Center
Brooklyn, NY 11218
Phone (718) 826-4000
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
Enrollment records 1
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1573881 | NY | MD | Family Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Young Adult Institute, Inc. | Current | Accepting new patients | |
| Premier Healthcare, Inc. | Current | Accepting new patients | |
| Premier Healthcare, Inc. | Current | Accepting new patients | |
| Harmony Medical Services of New York, PLLC | Family Medicine | Current | Accepting new patients |
| Park Avenue Medical Associates, P.C. | Past | Accepting new patients |
Locations
21111 Northern Blvd
Bayside, NY 11361
Phone (212) 563-7474
11835 Queens Blvd
Ste 400
Forest Hills, NY 11375
Phone (646) 722-7610
460 W 34th St
Fl 9
New York, NY 10001
Phone (212) 273-6515
1802 Petracca Pl
Ste 103
Whitestone, NY 11357
Phone (646) 722-7610
Interoperability endpoints
- michael.crismali.1@32913.direct.athenahealth.com
Organizations & group practices 5
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.
-
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- Whitestone, NY
- NPI 1669178448
-
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- NPI 1760436190
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- Developmental Disabilities Clinic/Center
- New York, NY
- NPI 1831330182
-
- Developmental Disabilities Clinic/Center
- New York, NY
- NPI 1144314576
-
- Geriatric Medicine (Family Medicine) Physician
- White Plains, NY
- NPI 1730138645
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1153180800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1722816000000",
"number": "1053339838",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 639295",
"city": "CINCINNATI",
"state": "OH",
"postal_code": "452639295",
"telephone_number": "248-266-4200",
"fax_number": "855-618-6655"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "11835 QUEENS BLVD STE 400",
"city": "FOREST HILLS",
"state": "NY",
"postal_code": "113757211",
"telephone_number": "646-722-7610"
}
],
"practiceLocations": [
{
"address_1": "1000 Church Ave",
"address_2": "Flatbush Center",
"address_purpose": "LOCATION",
"city": "Brooklyn",
"state": "NY",
"postal_code": "11218",
"country_code": "US",
"telephone_number": "718-826-4000",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "CRISMALI",
"first_name": "MICHAEL",
"middle_name": "C",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-07-18",
"last_updated": "2024-08-05",
"certification_date": "2024-08-05",
"status": "A"
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "NY",
"license": "1573881",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Forest Hills, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 5, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.