East Summit Medical PC

Primary specialty

Gastroenterology PhysicianTaxonomy code 207RG0100X

Legal business name

EAST SUMMIT MEDICAL PC

Practice address

40 Bowery # Ground
New York, NY 10013-4801

Phone

(646) 609-6138

NPI assigned

May 17, 2019

Organization subpart

No

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

Authorized official

Name

Kevin TinNPI 1174812044

Title

Administrator

Phone

(917) 336-8422

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in NY

Enrollment records 1

Locations

Practitioners 13

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

• Kevin Tin, M.D.

  • Gastroenterology Physician
  • Brooklyn, NY
  • NPI 1174812044

  Single Specialty

  Medicare reassignment Care Compare group NPD Authorized official
• Ted Lao, MD

  • Nephrology Physician
  • New York, NY
  • NPI 1073007712
  Medicare reassignment Care Compare group NPD
• Wai Loon Bong, PA

  • Medical Physician Assistant
  • Flushing, NY
  • NPI 1184020315
  Medicare reassignment NPD
• Tuo Chen, DO

  • Family Medicine Physician
  • New York, NY
  • NPI 1609338870
  Medicare reassignment NPD
• Mark Ilyagu, MD

  • Internal Medicine Physician
  • Brooklyn, NY
  • NPI 1073994711
  Medicare reassignment NPD
• Horace Tang, M.D.

  • Hematology & Oncology Physician
  • Brooklyn, NY
  • NPI 1073833984
  Medicare reassignment NPD
• Yuqing Raine Chen

  • Adult Health Nurse Practitioner
  • Flushing, NY
  • NPI 1174057087
  NPD
• Stephanie Lau, PA

  • Medical Physician Assistant
  • Flushing, NY
  • NPI 1205340148
  NPD
• Lili Lin

  • Adult Health Nurse Practitioner
  • Jamaica, NY
  • NPI 1760757538
  NPD
• Tony Bao, FNP-C

  • Family Nurse Practitioner
  • Brooklyn, NY
  • NPI 1265838874
  NPD (past)
• Michael Xin Chen, M.D.

  • Internal Medicine Physician
  • Flushing, NY
  • NPI 1013303577
  NPD (past)
• Xiao Yan Hu, PA

  • Physician Assistant
  • Brooklyn, NY
  • NPI 1972224426
  NPD (past)

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

{
    "created_epoch": "1558051200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1670284800000",
    "number": "1093371742",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7116 GRAND AVE",
            "city": "MASPETH",
            "state": "NY",
            "postal_code": "113781823",
            "telephone_number": "646-609-6138"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "40 BOWERY # GROUND",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100134801",
            "telephone_number": "646-609-6138"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EAST SUMMIT MEDICAL PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-05-17",
        "last_updated": "2022-12-06",
        "certification_date": "2022-12-06",
        "status": "A",
        "authorized_official_last_name": "TIN",
        "authorized_official_first_name": "KEVIN",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "917-336-8422"
    },
    "taxonomies": [
        {
            "code": "207RG0100X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine, Gastroenterology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Gastroenterology Physician in New York, NY
• Providers in New York, NY by specialty
• Gastroenterology Physician in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 6, 2022; 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.