Organization Active NPI

Jamaica Medical Care PC

  • Internal Medicine Physician
  • Jamaica, NY
National Provider Identifier
1205944261
Registry record updated Mar 24, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
213299 Issued in NY
Legal business name
JAMAICA MEDICAL CARE PC
Practice address
17206 Jamaica Ave
Jamaica, NY 11432-5522
Phone
(718) 526-4211
Fax
(718) 526-4166
NPI assigned
Aug 29, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 24, 2010

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

Authorized official

Name
Dr. Tristan Da Cunha, MD
Title
President
Phone
(718) 526-4211

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207R00000X 213299 NY Primary

Addresses

Primary practice location

17206 Jamaica Ave
Jamaica, NY 11432-5522

Mailing address

17206 Jamaica Ave
Jamaica, NY 11432-5522
Phone (718) 526-4211

Other identifiers 1

IdentifierTypeStateIssuer
01995248MedicaidNY

National Provider Directory

National Provider Directory

Locations

17206 Jamaica Ave
Jamaica, NY 11432
Phone (718) 526-4211

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": "1156809600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1269388800000",
    "number": "1205944261",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17206 JAMAICA AVE",
            "city": "JAMAICA",
            "state": "NY",
            "postal_code": "114325522",
            "telephone_number": "718-526-4211",
            "fax_number": "718-526-4166"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17206 JAMAICA AVE",
            "city": "JAMAICA",
            "state": "NY",
            "postal_code": "114325522",
            "telephone_number": "718-526-4211",
            "fax_number": "718-526-4166"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JAMAICA MEDICAL CARE PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-29",
        "last_updated": "2010-03-24",
        "status": "A",
        "authorized_official_last_name": "DA CUNHA",
        "authorized_official_first_name": "TRISTAN",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "718-526-4211",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine",
            "state": "NY",
            "license": "213299",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01995248",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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 Mar 24, 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.