Prospect Medical Group

Primary specialty

SpecialistTaxonomy code 174400000X

Legal business name

PROSPECT MEDICAL GROUP

Practice address

15 Woodcrest Dr
Syosset, NY 11791-3036

Phone

(718) 613-4442

NPI assigned

Mar 13, 2008

Organization subpart

No

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

Authorized official

Name

Mr. Darin Dunn

Title

Practice Manager

Phone

(718) 613-4442

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1205366400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1206316800000",
    "number": "1114198504",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "555 PROSPECT PL",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112384266",
            "telephone_number": "718-613-4442"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15 WOODCREST DR",
            "city": "SYOSSET",
            "state": "NY",
            "postal_code": "117913036",
            "telephone_number": "718-613-4442"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PROSPECT MEDICAL GROUP",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-03-13",
        "last_updated": "2008-03-24",
        "status": "A",
        "authorized_official_last_name": "DUNN",
        "authorized_official_first_name": "DARIN",
        "authorized_official_title_or_position": "PRACTICE MANAGER",
        "authorized_official_telephone_number": "718-613-4442",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Specialist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Specialist in Syosset, NY
• Providers in Syosset, NY by specialty
• Specialist in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 24, 2008; 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.