Organization Active NPI

Kew Gardens Family Physicians, LLP

  • Family Medicine Physician
  • Kew Gardens, NY
National Provider Identifier
1093759326
Registry record updated Jan 14, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
172844, 171010 Issued in NY
Legal business name
KEW GARDENS FAMILY PHYSICIANS, LLP
Practice address
11940 Metropolitan Ave
Suite E1
Kew Gardens, NY 11415-2600
Phone
(718) 849-0624
Fax
(718) 849-4935
NPI assigned
Jun 16, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 14, 2008

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

Authorized official

Name
Ms. Kim Parolisi
Title
Medical Biller
Phone
(718) 849-0624

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207Q00000X 172844, 171010 NY Primary

Addresses

Primary practice location

11940 Metropolitan Ave
Suite E1
Kew Gardens, NY 11415-2600

Mailing address

11940 Metropolitan Ave
Suite E1
Kew Gardens, NY 11415-2600
Phone (718) 849-0624

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20061016000187 NY Part B Supplier - Clinic/Group Practice 5991701997 Receives reassigned benefits from 3 practitioners
Practice locations: Kew Gardens, NY

National Provider Directory

National Provider Directory

Locations

11940 Metropolitan Ave
Apt E1
Kew Gardens, NY 11415

Practitioners & affiliated clinicians

Practitioners 4

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": "1150416000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1200268800000",
    "number": "1093759326",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11940 METROPOLITAN AVE",
            "address_2": "SUITE E1",
            "city": "KEW GARDENS",
            "state": "NY",
            "postal_code": "114152600",
            "telephone_number": "718-849-0624",
            "fax_number": "718-849-4935"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11940 METROPOLITAN AVE",
            "address_2": "SUITE E1",
            "city": "KEW GARDENS",
            "state": "NY",
            "postal_code": "114152600",
            "telephone_number": "718-849-0624",
            "fax_number": "718-849-4935"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KEW GARDENS FAMILY PHYSICIANS, LLP",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-16",
        "last_updated": "2008-01-14",
        "status": "A",
        "authorized_official_last_name": "PAROLISI",
        "authorized_official_first_name": "KIM",
        "authorized_official_title_or_position": "MEDICAL BILLER",
        "authorized_official_telephone_number": "718-849-0624",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": "NY",
            "license": "172844, 171010",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Kew Gardens, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 14, 2008; 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.