Organization Active NPI

Farmingdale Primary Care PC

  • Family Medicine Physician
  • Farmingdale, NY
National Provider Identifier
1073820965
Registry record updated Sep 13, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
234805 Issued in NY
Legal business name
FARMINGDALE PRIMARY CARE PC
Practice address
202 Fallwood Pkwy
Farmingdale, NY 11735-4929
Phone
(516) 249-1999
Fax
(516) 249-1911
NPI assigned
Sep 13, 2010
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 13, 2010

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

Authorized official

Name
Dr. Ronan Monsef, D.O.NPI 1528132594
Title
Medical Director
Phone
(516) 249-1999

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207Q00000X 234805 NY Primary

Addresses

Primary practice location

202 Fallwood Pkwy
Farmingdale, NY 11735-4929

Mailing address

202 Fallwood Pkwy
Farmingdale, NY 11735-4929
Phone (516) 249-1999

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20101201001335 NY Part B Supplier - Clinic/Group Practice 0143416164 Receives reassigned benefits from 3 practitioners
Practice locations: Massapequa, NY

National Provider Directory

National Provider Directory

Locations

1 Stuart Gate
#B
North Massapequa, NY 11758
Phone (516) 249-1999

Practitioners & affiliated clinicians

Practitioners 3

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

NPI Registry JSON

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

{
    "created_epoch": "1284336000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1284336000000",
    "number": "1073820965",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "202 FALLWOOD PKWY",
            "city": "FARMINGDALE",
            "state": "NY",
            "postal_code": "117354929",
            "telephone_number": "516-249-1999",
            "fax_number": "516-249-1911"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "202 FALLWOOD PKWY",
            "city": "FARMINGDALE",
            "state": "NY",
            "postal_code": "117354929",
            "telephone_number": "516-249-1999",
            "fax_number": "516-249-1911"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FARMINGDALE PRIMARY CARE PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-09-13",
        "last_updated": "2010-09-13",
        "status": "A",
        "authorized_official_last_name": "MONSEF",
        "authorized_official_first_name": "RONAN",
        "authorized_official_title_or_position": "MEDICAL DIRECTOR",
        "authorized_official_telephone_number": "516-249-1999",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.O."
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": "NY",
            "license": "234805",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Farmingdale, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 13, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.