NPIMap

Organization Active NPI

Preferred Professional Medical Care PC

  • Internal Medicine Physician
  • Ronkonkoma, NY
National Provider Identifier
1083916670
Registry record updated Oct 5, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
Legal business name
PREFERRED PROFESSIONAL MEDICAL CARE PC
Practice address
3505 Veterans Memorial Hwy
Suite C
Ronkonkoma, NY 11779-7640
Phone
(631) 676-7656
Fax
(631) 676-7648
NPI assigned
Dec 2, 2010
Last updated
Oct 5, 2012By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 5, 2012

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

Authorized official

Name
Wei K Kao, M.D.NPI 1629295571
Title
President
Phone
(631) 676-7656

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
Internal Medicine Physician 207R00000X Primary

Addresses

Primary practice location

3505 Veterans Memorial Hwy
Suite C
Ronkonkoma, NY 11779-7640

Mailing address

3505 Veterans Memorial Hwy
Suite C
Ronkonkoma, NY 11779-7640
Phone (631) 676-7656

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20110824000026 NY Part B Supplier - Clinic/Group Practice 9739359027 Receives reassigned benefits from 37 practitioners
Practice locations: Ronkonkoma, NY

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 37

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 37

NPI Registry JSON

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

{
    "created_epoch": "1291248000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1349395200000",
    "number": "1083916670",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3505 VETERANS MEMORIAL HWY",
            "address_2": "SUITE C",
            "city": "RONKONKOMA",
            "state": "NY",
            "postal_code": "117797640",
            "telephone_number": "631-676-7656",
            "fax_number": "631-676-7648"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3505 VETERANS MEMORIAL HWY",
            "address_2": "SUITE C",
            "city": "RONKONKOMA",
            "state": "NY",
            "postal_code": "117797640",
            "telephone_number": "631-676-7656",
            "fax_number": "631-676-7648"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PREFERRED PROFESSIONAL MEDICAL CARE PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-12-02",
        "last_updated": "2012-10-05",
        "status": "A",
        "authorized_official_last_name": "KAO",
        "authorized_official_first_name": "WEI",
        "authorized_official_middle_name": "K",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "631-676-7656",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ronkonkoma, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 5, 2012; 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.