Organization Active NPI

Carefirst Family Medical PC

  • Primary Care Clinic/Center
  • Commack, NY
National Provider Identifier
1174719496
Registry record updated Sep 20, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Primary Care Clinic/CenterTaxonomy code 261QP2300X
License
240642 Issued in NY
Legal business name
CAREFIRST FAMILY MEDICAL PC
Practice address
353 Veterans Memorial Hwy
Commack, NY 11725-4200
Phone
(631) 864-8535
Fax
(631) 864-8504
NPI assigned
Sep 20, 2007
Last updated
Sep 20, 2007By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 20, 2007

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

Authorized official

Name
Dr. Fangqin Li, MDNPI 1427198076
Title
Director
Phone
(631) 751-6389

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
Primary Care Clinic/Center 261QP2300X 240642 NY Primary

Addresses

Primary practice location

353 Veterans Memorial Hwy
Commack, NY 11725-4200

Mailing address

163 Sycamore Cir
Stony Brook, NY 11790-3171
Phone (631) 751-6389

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20071003000019 NY Part B Supplier - Clinic/Group Practice 9133214398 Receives reassigned benefits from 1 practitioner
Practice locations: Stony Brook, NY

National Provider Directory

National Provider Directory

Locations

2500 Nesconset Hwy
Bldg 12C
Stony Brook, NY 11790
Phone (631) 675-9555

2500 Route 347
Bldg 6D
Stony Brook, NY 11790
Phone (631) 675-1895

Practitioners & affiliated clinicians

Practitioners 3

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": "1190246400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1190246400000",
    "number": "1174719496",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "163 SYCAMORE CIR",
            "city": "STONY BROOK",
            "state": "NY",
            "postal_code": "117903171",
            "telephone_number": "631-751-6389"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "353 VETERANS MEMORIAL HWY",
            "city": "COMMACK",
            "state": "NY",
            "postal_code": "117254200",
            "telephone_number": "631-864-8535",
            "fax_number": "631-864-8504"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CAREFIRST FAMILY MEDICAL PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-09-20",
        "last_updated": "2007-09-20",
        "status": "A",
        "authorized_official_last_name": "LI",
        "authorized_official_first_name": "FANGQIN",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "631-751-6389",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": "NY",
            "license": "240642",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Commack, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 20, 2007; 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.