Organization Active NPI

Rochdale Obstetrics & Gynecology P C

  • Specialist
  • Queens Village, NY
National Provider Identifier
1104156975
Registry record updated Mar 19, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
180484 Issued in NY
Legal business name
ROCHDALE OBSTETRICS & GYNECOLOGY P C
Practice address
21626 Jamaica Ave
Queens Village, NY 11428-2121
Phone
(718) 217-1602
Fax
(718) 217-1790
NPI assigned
Dec 30, 2009
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 19, 2014

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

Authorized official

Name
Orin Pearce, M.DNPI 1891821609
Title
Owner
Phone
(718) 217-1602

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
SpecialistGroup: 193200000X MULTI-SPECIALTY GROUP 174400000X 180484 NY Primary

Addresses

Primary practice location

21626 Jamaica Ave
Queens Village, NY 11428-2121

Mailing address

21626 Jamaica Ave
Queens Village, NY 11428-2121
Phone (718) 217-1602

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20140522001326 NY Part B Supplier - Clinic/Group Practice 4880817725 Receives reassigned benefits from 1 practitioner
Practice locations: Queens Village, NY

National Provider Directory

National Provider Directory

Locations

21626 Jamaica Ave
Queens Village, NY 11428
Phone (718) 217-1602

Practitioners & affiliated clinicians

Practitioners 1

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": "1262131200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1395187200000",
    "number": "1104156975",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "21626 JAMAICA AVE",
            "city": "QUEENS VILLAGE",
            "state": "NY",
            "postal_code": "114282121",
            "telephone_number": "718-217-1602",
            "fax_number": "718-217-1790"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "21626 JAMAICA AVE",
            "city": "QUEENS VILLAGE",
            "state": "NY",
            "postal_code": "114282121",
            "telephone_number": "718-217-1602",
            "fax_number": "718-217-1790"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ROCHDALE OBSTETRICS & GYNECOLOGY P C",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-12-30",
        "last_updated": "2014-03-19",
        "status": "A",
        "authorized_official_last_name": "PEARCE",
        "authorized_official_first_name": "ORIN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "718-217-1602",
        "authorized_official_credential": "M.D"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Specialist",
            "state": "NY",
            "license": "180484",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Queens Village, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 19, 2014; 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.