Individual provider Active NPI

Charles Famulare, MD

  • Internal Medicine Physician
  • East Meadow, NY
National Provider Identifier
1063469328
Registry record updated Apr 10, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
195796 Issued in NY
Practice address
2201 Hempstead Tpke
East Meadow, NY 11554-1859
Phone
(516) 572-3924
NPI assigned
May 30, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 10, 2008

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 195796 NY Primary

Addresses

Primary practice location

2201 Hempstead Tpke
East Meadow, NY 11554-1859

Mailing address

2201 Hempstead Tpke
East Meadow, NY 11554-1859
Phone (516) 572-3924

Other identifiers 1

IdentifierTypeStateIssuer
01565122MedicaidNY

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
I20050601000242 NY Practitioner - Internal MedicinePractitioner - General Practice 4688616584 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 1989
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Harmony Health Care Long IslandGroup PAC ID 5991970535, 24 clinicians

Practice addresses (Care Compare)

101 S Bergen PL
Freeport, NY 11520-3528
Phone (516) 623-3600

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
195796NYMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Harmony Health Care Long Island CurrentSince Jan 4, 2016 Accepting new patients
Harmony Health Care Long Island Current Accepting new patients
Harmony Health Care Long Island CurrentSince Jan 4, 2016 Accepting new patients
Elmont Community Health Center Past Accepting new patients

Locations

161 Hempstead Tpke
Elmont, NY 11003
Phone (516) 571-8200

101 S Bergen Pl
Freeport, NY 11520
Phone (516) 623-3600

135 Main St
Hempstead, NY 11550
Phone (516) 292-3111

682 Union Ave
Westbury, NY 11590
Phone (516) 571-9500

Networks

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

Interoperability endpoints

  • Direct secure messaging: charles.famulare@lifqhc.eclinicaldirectplus.com

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": "1148947200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1207785600000",
    "number": "1063469328",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2201 HEMPSTEAD TPKE",
            "city": "EAST MEADOW",
            "state": "NY",
            "postal_code": "115541859",
            "telephone_number": "516-572-3924"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2201 HEMPSTEAD TPKE",
            "city": "EAST MEADOW",
            "state": "NY",
            "postal_code": "115541859",
            "telephone_number": "516-572-3924"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FAMULARE",
        "first_name": "CHARLES",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-05-30",
        "last_updated": "2008-04-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NY",
            "license": "195796",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01565122",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in East Meadow, NY

Sources for this page

Verify at the official NPI Registry.