Active NPI
Elizabeth Madrigal
- Pediatrics Physician
- Flushing, NY
National Provider Identifier
1073701249
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatrics Physician
- License
- 190809-1
- Practice address
- 4500 Parsons Blvd
Flushing, NY 11355-2205 - Phone
- (718) 670-8939
- Fax
- (718) 670-5069
- NPI assigned
- Oct 12, 2007
- Sex
- Female
- 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 |
|---|---|---|---|---|
| Pediatrics Physician | 208000000X | 190809-1 | NY | Primary |
Addresses
Primary practice location
4500 Parsons Blvd
Flushing, NY 11355-2205
Mailing address
80 Marcus Dr
Melville, NY 11747-4230
Phone (631) 391-8366
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 01377068 | Medicaid | NY |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 190809-1 | NY | MD | Pediatrics Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1192147200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1192147200000",
"number": "1073701249",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "80 MARCUS DR",
"city": "MELVILLE",
"state": "NY",
"postal_code": "117474230",
"telephone_number": "631-391-8366",
"fax_number": "631-454-4163"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4500 PARSONS BLVD",
"city": "FLUSHING",
"state": "NY",
"postal_code": "113552205",
"telephone_number": "718-670-8939",
"fax_number": "718-670-5069"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MADRIGAL",
"first_name": "ELIZABETH",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-10-12",
"last_updated": "2007-10-12",
"status": "A"
},
"taxonomies": [
{
"code": "208000000X",
"taxonomy_group": "",
"desc": "Pediatrics",
"state": "NY",
"license": "190809-1",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "01377068",
"state": "NY"
}
],
"endpoints": [],
"other_names": []
}Other providers in Flushing, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 12, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.