Organization Active NPI

United Medical Practice, P.C.

  • Internal Medicine Physician
  • Jamaica, NY
National Provider Identifier
1194355586
Registry record updated Jun 9, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
Legal business name
UNITED MEDICAL PRACTICE, P.C.
Practice address
17933 90TH Ave
Jamaica, NY 11432-4763
Phone
(718) 657-2706
Fax
(718) 657-2420
NPI assigned
Jan 24, 2020
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 9, 2020

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

Authorized official

Name
Zenaida Espino SantosNPI 1396743266
Title
MD
Phone
(718) 565-0444

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
Internal Medicine PhysicianGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 207R00000X Primary

Addresses

Primary practice location

17933 90TH Ave
Jamaica, NY 11432-4763

Mailing address

7704 Broadway
Elmhurst, NY 11373-1927
Phone (718) 565-3144

Other practice location 1

7708 Broadway
Elmhurst, NY 11373-1927
Phone (718) 565-3144

Other names 1

  • United Medical Practice, P.C. Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20200818000766 NY Part B Supplier - Clinic/Group Practice 5698191997 Receives reassigned benefits from 1 practitioner
Practice locations: Elmhurst, NY; Jamaica, NY

National Provider Directory

National Provider Directory

Locations

7704 Broadway
Elmhurst, NY 11373
Phone (718) 396-3147

7708 Broadway
Flushing, NY 11373
Phone (347) 806-7706

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": "1579824000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1591660800000",
    "number": "1194355586",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7704 BROADWAY",
            "city": "ELMHURST",
            "state": "NY",
            "postal_code": "113731927",
            "telephone_number": "718-565-3144",
            "fax_number": "718-639-6409"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17933 90TH AVE",
            "city": "JAMAICA",
            "state": "NY",
            "postal_code": "114324763",
            "telephone_number": "718-657-2706",
            "fax_number": "718-657-2420"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "7708 Broadway",
            "address_purpose": "LOCATION",
            "city": "Elmhurst",
            "state": "NY",
            "postal_code": "113731927",
            "country_code": "US",
            "telephone_number": "718-565-3144",
            "fax_number": "718-639-6409",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "UNITED MEDICAL PRACTICE, P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-01-24",
        "last_updated": "2020-06-09",
        "certification_date": "2020-06-09",
        "status": "A",
        "authorized_official_last_name": "SANTOS",
        "authorized_official_first_name": "ZENAIDA",
        "authorized_official_middle_name": "ESPINO",
        "authorized_official_title_or_position": "MD",
        "authorized_official_telephone_number": "718-565-0444"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "United Medical Practice, P.C.",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Jamaica, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 9, 2020; 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.