NPIMap

Organization Active NPI

CMC Housestaff

  • Family Medicine Physician
  • Elmhurst, NY
National Provider Identifier
1063572212
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
CMC HOUSESTAFF
Practice address
9002 Queens Blvd
Elmhurst, NY 11373-4941
Phone
(718) 558-1000
Fax
(212) 356-4608
NPI assigned
Dec 11, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Mr. Michael A Calder
Title
Senior VP of Revenue Cycle
Phone
(212) 356-5944

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207Q00000X Primary

Addresses

Primary practice location

9002 Queens Blvd
Elmhurst, NY 11373-4941

Mailing address

9002 Queens Blvd
Elmhurst, NY 11373-4941
Phone (718) 558-1000

Other names 1

  • ST VINCENTS CATHOLIC MEDICAL CENTER Doing business as

National Provider Directory

National Provider Directory

Locations

111 W 40th St
Fl 11
New York, NY 10018

9525 Queens Blvd
Ste 1
Rego Park, NY 11374
Phone (718) 558-6200

Practitioners 131

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

View all 131

NPI Registry JSON

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

{
    "created_epoch": "1165795200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1063572212",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9002 QUEENS BLVD",
            "city": "ELMHURST",
            "state": "NY",
            "postal_code": "113734941",
            "telephone_number": "718-558-1000",
            "fax_number": "212-356-4608"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9002 QUEENS BLVD",
            "city": "ELMHURST",
            "state": "NY",
            "postal_code": "113734941",
            "telephone_number": "718-558-1000",
            "fax_number": "212-356-4608"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CMC HOUSESTAFF",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-11",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "CALDER",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "SENIOR VP OF REVENUE CYCLE",
        "authorized_official_telephone_number": "212-356-5944",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "ST VINCENTS CATHOLIC MEDICAL CENTER",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Elmhurst, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.