Organization Active NPI

New York Family Practice PLLC

  • Family Medicine Physician
  • New York, NY
National Provider Identifier
1093721383
Registry record updated Nov 4, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
210846 Issued in NY
Legal business name
NEW YORK FAMILY PRACTICE PLLC
Practice address
4960 Broadway
Ste 1C
New York, NY 10034
Phone
(212) 304-0682
Fax
(212) 569-1967
NPI assigned
Jul 31, 2006
Last updated
Nov 4, 2010By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 4, 2010

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

Authorized official

Name
Michael Platzman, DONPI 1093742942
Title
Owner
Phone
(212) 304-0682

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 210846 NY Primary

Addresses

Primary practice location

4960 Broadway
Ste 1C
New York, NY 10034

Mailing address

PO Box 452
Irvington, NY 10533
Phone (212) 304-0682

Other identifiers 1

IdentifierTypeStateIssuer
01861852MedicaidNY

National Provider Directory

National Provider Directory

Locations

4960 Broadway
Apt 1C
New York, NY 10034
Phone (212) 304-0682

Practitioners & affiliated clinicians

Practitioners 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1154304000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1288828800000",
    "number": "1093721383",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 452",
            "city": "IRVINGTON",
            "state": "NY",
            "postal_code": "10533",
            "telephone_number": "212-304-0682",
            "fax_number": "212-569-1967"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4960 BROADWAY",
            "address_2": "STE 1C",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "10034",
            "telephone_number": "212-304-0682",
            "fax_number": "212-569-1967"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NEW YORK FAMILY PRACTICE PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-31",
        "last_updated": "2010-11-04",
        "status": "A",
        "authorized_official_last_name": "PLATZMAN",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "212-304-0682",
        "authorized_official_credential": "DO"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NY",
            "license": "210846",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01861852",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 4, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.