NPIMap

Organization Active NPI

Nassau Medical Home Visits P.C.

  • Internal Medicine Physician
  • Syosset, NY
National Provider Identifier
1104270198
Registry record updated Jun 25, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
Legal business name
NASSAU MEDICAL HOME VISITS P.C.
Practice address
60 Queens St
Suite 100
Syosset, NY 11791-3058
Phone
(631) 271-9151
NPI assigned
Apr 16, 2016
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 25, 2016

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

Authorized official

Name
Grigoriy Krichmar
Title
Owner
Phone
(631) 271-9151

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207R00000X Primary
Physician AssistantGroup: 193200000X MULTI-SPECIALTY GROUP 363A00000X
Nurse PractitionerGroup: 193200000X MULTI-SPECIALTY GROUP 363L00000X

Addresses

Primary practice location

60 Queens St
Suite 100
Syosset, NY 11791-3058

Mailing address

60 Queens St
Suite 100
Syosset, NY 11791-3058

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20160708000731 NY Part B Supplier - Clinic/Group Practice 8921390121 Receives reassigned benefits from 20 practitioners
Practice locations: Syosset, NY

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 22

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

View all 22

NPI Registry JSON

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

{
    "created_epoch": "1460764800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1466812800000",
    "number": "1104270198",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "60 QUEENS ST",
            "address_2": "SUITE 100",
            "city": "SYOSSET",
            "state": "NY",
            "postal_code": "117913058"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "60 QUEENS ST",
            "address_2": "SUITE 100",
            "city": "SYOSSET",
            "state": "NY",
            "postal_code": "117913058",
            "telephone_number": "631-271-9151"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NASSAU MEDICAL HOME VISITS P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-04-16",
        "last_updated": "2016-06-25",
        "status": "A",
        "authorized_official_last_name": "KRICHMAR",
        "authorized_official_first_name": "GRIGORIY",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "631-271-9151"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Syosset, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 25, 2016; 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.