Organization Active NPI

Ozone Park Quality Care Medicine PLLC

  • Primary Care Clinic/Center
  • Ozone Park, NY
National Provider Identifier
1205336591
Registry record updated Sep 5, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Primary Care Clinic/CenterTaxonomy code 261QP2300X
License
285335 Issued in NY
Legal business name
OZONE PARK QUALITY CARE MEDICINE PLLC
Practice address
7721 101St Ave FL 1
Ozone Park, NY 11416
Phone
(718) 322-4014
Fax
(718) 322-4015
NPI assigned
Feb 14, 2018
Last updated
Sep 5, 2018By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 5, 2018

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

Authorized official

Name
Musammat Rounak Jahan, MDNPI 1699188680
Title
Owner
Phone
(718) 322-4014

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 2

Specialty (taxonomy)CodeLicenseStatePrimary
Primary Care Clinic/Center 261QP2300X 285335 NY Primary
Primary Care Clinic/Center 261QP2300X

Addresses

Primary practice location

7721 101St Ave FL 1
Ozone Park, NY 11416

Mailing address

1 Jara CT
New Hyde Park, NY 11040-3117
Phone (718) 322-4014

Other practice location 1

7721 101st Ave Fl Fist
Ozone Park, NY 11416-1915
Phone (718) 322-4014

Other identifiers 1

IdentifierTypeStateIssuer
1699188680MedicaidNY

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20180612000048 NY Part B Supplier - Clinic/Group Practice 6507111796 Receives reassigned benefits from 1 practitioner
Practice locations: Ozone Park, NY

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 2

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": "1518566400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1536105600000",
    "number": "1205336591",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 JARA CT",
            "city": "NEW HYDE PARK",
            "state": "NY",
            "postal_code": "110403117",
            "telephone_number": "718-322-4014",
            "fax_number": "718-322-4015"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7721 101ST AVE FL 1",
            "city": "OZONE PARK",
            "state": "NY",
            "postal_code": "11416",
            "telephone_number": "718-322-4014",
            "fax_number": "718-322-4015"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "7721 101st Ave Fl Fist",
            "address_purpose": "LOCATION",
            "city": "Ozone Park",
            "state": "NY",
            "postal_code": "114161915",
            "country_code": "US",
            "telephone_number": "718-322-4014",
            "fax_number": "718-322-4015",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "OZONE PARK QUALITY CARE MEDICINE PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-02-14",
        "last_updated": "2018-09-05",
        "status": "A",
        "authorized_official_last_name": "JAHAN",
        "authorized_official_first_name": "MUSAMMAT",
        "authorized_official_middle_name": "ROUNAK",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "718-322-4014",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": "NY",
            "license": "285335",
            "primary": true
        },
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1699188680",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Ozone Park, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 5, 2018; 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.