Innovative Medical Care PLLC

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

233446 Issued in NY

Legal business name

INNOVATIVE MEDICAL CARE PLLC

Practice address

375 Commack Rd Unit a
Deer Park, NY 11729-5522

Phone

(631) 940-1834

Fax

(631) 940-1834

NPI assigned

Sep 14, 2010

Organization subpart

No

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

Authorized official

Name

Behrouz Farahmandpour, DONPI 1447246756

Title

President

Phone

(631) 940-0409

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in NY

Enrollment records 1

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Locations

Practitioners 5

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

• Behrouz Farahmandpour, D.O.

  • Family Medicine Physician
  • Deer Park, NY
  • NPI 1447246756
  Medicare reassignment NPD Authorized official
• Brian Gerson, NP

  • Family Nurse Practitioner
  • Deer Park, NY
  • NPI 1740552637
  Medicare reassignment NPD
• Irene Eng

  • Physician Assistant
  • Middletown, NY
  • NPI 1659460236
  Medicare reassignment
• Leroy Lott, L. AC.

  • Acupuncturist
  • Bellerose, NY
  • NPI 1568800928
  NPD (past)
• Andrea McFarlin, PT

  • Physical Therapist
  • Fresh Meadows, NY
  • NPI 1326460148
  NPD (past)

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

{
    "created_epoch": "1284422400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1743292800000",
    "number": "1063720910",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "375 COMMACK RD UNIT A",
            "city": "DEER PARK",
            "state": "NY",
            "postal_code": "117295522",
            "telephone_number": "631-940-1834",
            "fax_number": "631-940-1834"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "375 COMMACK RD UNIT A",
            "city": "DEER PARK",
            "state": "NY",
            "postal_code": "117295522",
            "telephone_number": "631-940-1834",
            "fax_number": "631-940-1834"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "24711 Union Tpke",
            "address_purpose": "LOCATION",
            "city": "Bellerose",
            "state": "NY",
            "postal_code": "114261846",
            "country_code": "US",
            "telephone_number": "631-940-0409",
            "fax_number": "631-940-1834",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "INNOVATIVE MEDICAL CARE PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-09-14",
        "last_updated": "2025-03-30",
        "certification_date": "2025-03-30",
        "status": "A",
        "authorized_official_last_name": "FARAHMANDPOUR",
        "authorized_official_first_name": "BEHROUZ",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "631-940-0409",
        "authorized_official_credential": "DO"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": "NY",
            "license": "233446",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Ronald Infantino, M.S
• Lisa Inglese, CD
• Interactive Creative Therapy Inc
• Saiqa Iram, MD
• Gaiana Isakov, D.D.S
• Island Life Chiropractic Pain Care PLLC
• Island Medical and Psychiatric PC

• Family Medicine Physician in Deer Park, NY
• Providers in Deer Park, NY by specialty
• Family Medicine Physician in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 30, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.