NPIMap

Organization Active NPI

Urgent Care Medical of New York, LLC

  • Urgent Care Clinic/Center
  • Baldwin Place, NY
National Provider Identifier
1154866879
Registry record updated Mar 14, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Urgent Care Clinic/CenterTaxonomy code 261QU0200X
Legal business name
URGENT CARE MEDICAL OF NEW YORK, LLC
Practice address
80 Route 6 Ste 704-705
Baldwin Place, NY 10505-1026
Phone
(860) 650-3848
NPI assigned
Jan 4, 2017
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 14, 2025

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

Authorized official

Name
Jeannie M Kenkare, DONPI 1245203231
Title
Managing Partner/Cmo
Phone
(860) 650-3848

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
Urgent Care Clinic/Center 261QU0200X Primary

Addresses

Primary practice location

80 Route 6 Ste 704-705
Baldwin Place, NY 10505-1026

Mailing address

PO Box 1339
Glastonbury, CT 06033-6339
Phone (860) 650-3848

Other practice location 1

3085 E Main St Ste 12A
Mohegan Lake, NY 10547-1542
Phone (860) 650-3848

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20170413000980 NY Part B Supplier - Clinic/Group Practice 5890071443 Receives reassigned benefits from 57 practitioners
Practice locations: Baldwin Place, NY

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 57

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

View all 57

NPI Registry JSON

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

{
    "created_epoch": "1483488000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1741910400000",
    "number": "1154866879",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1339",
            "city": "GLASTONBURY",
            "state": "CT",
            "postal_code": "060336339",
            "telephone_number": "860-650-3848"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "80 ROUTE 6 STE 704-705",
            "city": "BALDWIN PLACE",
            "state": "NY",
            "postal_code": "105051026",
            "telephone_number": "860-650-3848"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3085 E Main St Ste 12A",
            "address_purpose": "LOCATION",
            "city": "Mohegan Lake",
            "state": "NY",
            "postal_code": "105471542",
            "country_code": "US",
            "telephone_number": "860-650-3848",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "URGENT CARE MEDICAL OF NEW YORK, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-01-04",
        "last_updated": "2025-03-14",
        "certification_date": "2025-03-14",
        "status": "A",
        "authorized_official_last_name": "KENKARE",
        "authorized_official_first_name": "JEANNIE",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "MANAGING PARTNER/CMO",
        "authorized_official_telephone_number": "860-650-3848",
        "authorized_official_credential": "DO"
    },
    "taxonomies": [
        {
            "code": "261QU0200X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Urgent Care",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Baldwin Place, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 14, 2025; 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.