Organization Active NPI

Peak Medical Care P.C.

  • Internal Medicine Physician
  • Queens Village, NY
National Provider Identifier
1194028597
Registry record updated Dec 7, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
190765 Issued in NY
Legal business name
PEAK MEDICAL CARE P.C.
Practice address
21522 91St Ave
Queens Village, NY 11428-1217
Phone
(718) 217-0969
Fax
(718) 217-8247
NPI assigned
Dec 7, 2010
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 7, 2010

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

Authorized official

Name
Mario Lavelanet, M.D.
Title
President
Phone
(718) 217-0969

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207R00000X 190765 NY Primary

Addresses

Primary practice location

21522 91St Ave
Queens Village, NY 11428-1217

Mailing address

21522 91St Ave
Queens Village, NY 11428-1217
Phone (718) 217-0969

Other identifiers 1

IdentifierTypeStateIssuer
01616568MedicaidNY

Other names 1

  • Peak Medical Care P.C. Former legal business name

National Provider Directory

National Provider Directory

Practitioners & 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": "1291680000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1291680000000",
    "number": "1194028597",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "21522 91ST AVE",
            "city": "QUEENS VILLAGE",
            "state": "NY",
            "postal_code": "114281217",
            "telephone_number": "718-217-0969",
            "fax_number": "718-217-8247"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "21522 91ST AVE",
            "city": "QUEENS VILLAGE",
            "state": "NY",
            "postal_code": "114281217",
            "telephone_number": "718-217-0969",
            "fax_number": "718-217-8247"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PEAK MEDICAL CARE P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-12-07",
        "last_updated": "2010-12-07",
        "status": "A",
        "authorized_official_last_name": "LAVELANET",
        "authorized_official_first_name": "MARIO",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "718-217-0969",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine",
            "state": "NY",
            "license": "190765",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01616568",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Peak Medical Care P.C.",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

Other providers in Queens Village, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 7, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.