Individual provider Active NPI

Kamal A Tadros, M.D.

  • Internal Medicine Physician
  • Rosedale, NY
National Provider Identifier
1063467546
Registry record updated Jun 28, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
196376 Issued in NY
Practice address
235-20 147 Ave
Ste 1
Rosedale, NY 11422
Phone
(718) 276-1433
NPI assigned
May 23, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 28, 2019

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pulmonary Disease Physician 207RP1001X 196376 NY
Internal Medicine Physician 207R00000X 196376 NY Primary

Addresses

Primary practice location

235-20 147 Ave
Ste 1
Rosedale, NY 11422

Mailing address

235-20 147 Ave
Ste 1
Rosedale, NY 11422
Phone (718) 276-1433

Other identifiers 1

IdentifierTypeStateIssuer
01659594MedicaidNY

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
I20090918000060 NY Practitioner - Internal MedicinePractitioner - Pulmonary Disease 0941356877 Practice locations: Rosedale, NY

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
HHS exclusion list flag
Flagged The directory lists this NPI on an HHS exclusion list. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
KT Medical Healthcare PC Current Accepting new patients
Flushing Hospital & Medical Center Past Accepting new patients
Flushing Emergency Practice Plan Past Accepting new patients
Gastrointestinal Care of Long Island PLLC Past Accepting new patients

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": "1148342400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1561680000000",
    "number": "1063467546",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "235-20 147 AVE",
            "address_2": "STE 1",
            "city": "ROSEDALE",
            "state": "NY",
            "postal_code": "11422",
            "telephone_number": "718-276-1433"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "235-20 147 AVE",
            "address_2": "STE 1",
            "city": "ROSEDALE",
            "state": "NY",
            "postal_code": "11422",
            "telephone_number": "718-276-1433"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TADROS",
        "first_name": "KAMAL",
        "middle_name": "A",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-05-23",
        "last_updated": "2019-06-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RP1001X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Pulmonary Disease",
            "state": "NY",
            "license": "196376",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NY",
            "license": "196376",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01659594",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Rosedale, NY

Sources for this page

Verify at the official NPI Registry.