NPIMap

Organization Active NPI

Queens Medical Pavilion,LLC

  • Multi-Specialty Clinic/Center
  • Forest Hills, NY
National Provider Identifier
1124384136
Registry record updated Jan 15, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Multi-Specialty Clinic/CenterTaxonomy code 261QM1300X
Legal business name
QUEENS MEDICAL PAVILION,LLC
Practice address
6915 Austin St
Forest Hills, NY 11375-4255
Phone
(718) 263-3500
NPI assigned
Apr 3, 2012
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 15, 2026

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

Authorized official

Name
Ms. Erica Vazquez
Title
Manager
Phone
(718) 263-3500

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Multi-Specialty Clinic/Center 261QM1300X Primary

Addresses

Primary practice location

6915 Austin St
Forest Hills, NY 11375-4255

Mailing address

69-15 Austin St
Forest Hills, NY 11375
Phone (718) 263-3500

Other names 1

  • NY MED Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20130920000024 NY Part B Supplier - Clinic/Group Practice 0345484978 Receives reassigned benefits from 10 practitioners
Practice locations: Forest Hills, NY

National Provider Directory

National Provider Directory

Locations

6915 Austin St
Forest Hills, NY 11375
Phone (718) 263-3500

Practitioners & affiliated clinicians

Practitioners 11

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": "1333411200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1768435200000",
    "number": "1124384136",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "69-15 AUSTIN ST",
            "city": "FOREST HILLS",
            "state": "NY",
            "postal_code": "11375",
            "telephone_number": "718-263-3500"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6915 AUSTIN ST",
            "city": "FOREST HILLS",
            "state": "NY",
            "postal_code": "113754255",
            "telephone_number": "718-263-3500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "QUEENS MEDICAL PAVILION,LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-04-03",
        "last_updated": "2026-01-15",
        "certification_date": "2026-01-15",
        "status": "A",
        "authorized_official_last_name": "VAZQUEZ",
        "authorized_official_first_name": "ERICA",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "718-263-3500",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "261QM1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Multi-Specialty",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "NY MED",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Forest Hills, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 15, 2026; 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.