Organization Active NPI

Womens Medical Services of New York PC

  • Legal Medicine
  • Brooklyn, NY
National Provider Identifier
1184873572
Registry record updated Feb 12, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Legal MedicineTaxonomy code 173000000X
License
60 66418 Issued in NY
Legal business name
WOMENS MEDICAL SERVICES OF NEW YORK PC
Practice address
9413 Flatlands Ave
Suite 206
Brooklyn, NY 11236-3726
Phone
(718) 485-2420
NPI assigned
Sep 10, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 12, 2013

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

Authorized official

Name
Juan SandovalNPI 1770563272
Title
Sole Proprieter
Phone
(718) 485-2420

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
Legal MedicineGroup: 193200000X MULTI-SPECIALTY GROUP 173000000X 60 66418 NY Primary

Addresses

Primary practice location

9413 Flatlands Ave
Suite 206
Brooklyn, NY 11236-3726

Mailing address

2 Barnes LN
Garden City, NY 11530-4402
Phone (718) 485-2420

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20130115000189 NY Part B Supplier - Clinic/Group Practice 0547413916 Receives reassigned benefits from 6 practitioners
Practice locations: Brooklyn, NY; Howard Beach, NY

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 6

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": "1221004800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1360627200000",
    "number": "1184873572",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2 BARNES LN",
            "city": "GARDEN CITY",
            "state": "NY",
            "postal_code": "115304402",
            "telephone_number": "718-485-2420"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9413 FLATLANDS AVE",
            "address_2": "SUITE 206",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112363726",
            "telephone_number": "718-485-2420"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WOMENS MEDICAL SERVICES OF NEW YORK PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-09-10",
        "last_updated": "2013-02-12",
        "status": "A",
        "authorized_official_last_name": "SANDOVAL",
        "authorized_official_first_name": "JUAN",
        "authorized_official_title_or_position": "SOLE PROPRIETER",
        "authorized_official_telephone_number": "718-485-2420"
    },
    "taxonomies": [
        {
            "code": "173000000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Legal Medicine",
            "state": "NY",
            "license": "60 66418",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brooklyn, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 12, 2013; 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.