Active NPI
PCR Physician PLLC
Doing business as Omni Medical Health 360
- Internal Medicine Physician
- New Hyde Park, NY
National Provider Identifier
1184243040
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Internal Medicine Physician
- Legal business name
- PCR PHYSICIAN PLLC
- Doing business as
- Omni Medical Health 360
- Practice address
- 117 Greenway W
New Hyde Park, NY 11040-2226 - Phone
- (909) 757-8314
- NPI assigned
- Apr 10, 2020
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Dr. Kareem Abed, MD
- Title
- Owner
- Phone
- (609) 222-1198
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) | Code | License | State | Primary |
|---|---|---|---|---|
| Internal Medicine Physician | 207R00000X | Primary |
Addresses
Primary practice location
117 Greenway W
New Hyde Park, NY 11040-2226
Mailing address
117 Greenway W
New Hyde Park, NY 11040-2226
Phone (909) 757-8314
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 04607627 | Medicaid | NY | |
| 0669423 | Medicaid | NJ |
Other names 1
- Omni Medical Health 360
National Provider Directory
National Provider DirectoryPractitioners & affiliated clinicians
Practitioners 1
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": "1586476800000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1586476800000",
"number": "1184243040",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "117 GREENWAY W",
"city": "NEW HYDE PARK",
"state": "NY",
"postal_code": "110402226",
"telephone_number": "909-757-8314"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "117 GREENWAY W",
"city": "NEW HYDE PARK",
"state": "NY",
"postal_code": "110402226",
"telephone_number": "909-757-8314"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "PCR PHYSICIAN PLLC",
"organizational_subpart": "NO",
"enumeration_date": "2020-04-10",
"last_updated": "2020-04-10",
"certification_date": "2020-04-10",
"status": "A",
"authorized_official_last_name": "ABED",
"authorized_official_first_name": "KAREEM",
"authorized_official_title_or_position": "OWNER",
"authorized_official_telephone_number": "609-222-1198",
"authorized_official_name_prefix": "Dr.",
"authorized_official_credential": "MD"
},
"taxonomies": [
{
"code": "207R00000X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Internal Medicine",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "04607627",
"state": "NY"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "0669423",
"state": "NJ"
}
],
"endpoints": [],
"other_names": [
{
"organization_name": "Omni Medical Health 360",
"code": "3",
"type": "Doing Business As"
}
]
}Other providers in New Hyde Park, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 10, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.