NPIMap

Organization Active NPI

Namdor Inc

Doing business as Gristgogs Pharmacy 517

  • Pharmacist
  • Roosevelt Island, NY
National Provider Identifier
1174500292
Registry record updated Mar 7, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
024488 Issued in NY
Legal business name
NAMDOR INC
Doing business as
Gristgogs Pharmacy 517
Practice address
686 Main St
Roosevelt Island, NY 10044-0021
Phone
(212) 644-4125
Fax
(212) 644-0381
NPI assigned
Dec 29, 2005
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 7, 2023

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

Authorized official

Name
Mr. Barry Sherman
Title
Vice President
Phone
(917) 217-2789

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
PharmacistGroup: 193400000X SINGLE SPECIALTY GROUP 183500000X 024488 NY Primary

Addresses

Primary practice location

686 Main St
Roosevelt Island, NY 10044-0021

Mailing address

686 Main St
Roosevelt Island, NY 10044-0021
Phone (212) 644-4125

Other identifiers 2

IdentifierTypeStateIssuer
02002000MedicaidNY
3307798OtherNCPAP

Other names 1

  • Gristgogs Pharmacy 517 Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20100930003406 NY DME Supplier - PharmacyDME Supplier - Grocery Store 1153442306 Practice locations: Roosevelt Island, NY
O20201211001321 NY Part B Supplier - Mass Immunization (Roster Biller Only) 1153442306 2 other NPIs on this enrollment
Practice locations: Brooklyn, NY; New York, NY

Other NPIs with the same Medicare PAC ID 2

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

Other NPIs on the same Medicare enrollment 2

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

Medicare medical equipment & supply locations

SupplierSuppliesMedicare assignment
Namdor Inc686 N Main St, Roosevelt Island, NY 10044-0021(212) 644-4125 Epoetin|Immunosuppressive Drugs|Nebulizer Drugs|Oral Anticancer Drugs|Oral Antiemetic Drugs Does not accept assignmentParticipating since Dec 31, 1999

National Provider Directory

National Provider Directory

Locations

800 3rd Ave
Fl 5
New York, NY 10022

Practitioners & affiliated clinicians

Practitioners 5

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1135814400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1678147200000",
    "number": "1174500292",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "686 MAIN ST",
            "city": "ROOSEVELT ISLAND",
            "state": "NY",
            "postal_code": "100440021",
            "telephone_number": "212-644-4125",
            "fax_number": "212-644-0381"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "686 MAIN ST",
            "city": "ROOSEVELT ISLAND",
            "state": "NY",
            "postal_code": "100440021",
            "telephone_number": "212-644-4125",
            "fax_number": "212-644-0381"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NAMDOR INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-12-29",
        "last_updated": "2023-03-07",
        "status": "A",
        "authorized_official_last_name": "SHERMAN",
        "authorized_official_first_name": "BARRY",
        "authorized_official_title_or_position": "VICE PRESIDENT",
        "authorized_official_telephone_number": "917-217-2789",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Pharmacist",
            "state": "NY",
            "license": "024488",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02002000",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NCPAP",
            "identifier": "3307798",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Gristgogs Pharmacy 517",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Roosevelt Island, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 7, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.