Jackson Medical, PLLC

Primary specialty

Legal MedicineTaxonomy code 173000000X

License

225253 Issued in NY

Legal business name

JACKSON MEDICAL, PLLC

Practice address

7017 37TH Ave
Jackson Heights, NY 11372-3922

Phone

(718) 565-5600

Fax

(718) 565-5686

NPI assigned

Mar 27, 2006

Organization subpart

Yes

Parent organization

JACKSON MEDICAL, PLLCAs reported in NPPES

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

Authorized official

Name

Ferdous Khandker

Title

President

Phone

(718) 565-5600

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in NY

Enrollment records 1

Part of

Jackson Medical PLLC

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Ataul Hoque Mohammed Osmani, MD

  • Family Medicine Physician
  • Brooklyn, NY
  • NPI 1164498515
  Medicare reassignment
• Mohammed Shafiqulhaque Chowdhury, MD

  • Family Medicine Physician
  • Jackson Heights, NY
  • NPI 1396018933
  NPD (past)
• MD Mashiur Rahman Majumder, PA

  • Physician Assistant
  • Brooklyn, NY
  • NPI 1699201012
  NPD (past)
• Tahera Nasreen, M.D.

  • Internal Medicine Physician
  • Brooklyn, NY
  • NPI 1518193150
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1143417600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1205280000000",
    "number": "1235199852",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7017 37TH AVE",
            "city": "JACKSON HEIGHTS",
            "state": "NY",
            "postal_code": "113723922",
            "telephone_number": "718-565-5600",
            "fax_number": "718-565-5686"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7017 37TH AVE",
            "city": "JACKSON HEIGHTS",
            "state": "NY",
            "postal_code": "113723922",
            "telephone_number": "718-565-5600",
            "fax_number": "718-565-5686"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JACKSON MEDICAL, PLLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "JACKSON MEDICAL, PLLC",
        "enumeration_date": "2006-03-27",
        "last_updated": "2008-03-12",
        "status": "A",
        "authorized_official_last_name": "KHANDKER",
        "authorized_official_first_name": "FERDOUS",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "718-565-5600"
    },
    "taxonomies": [
        {
            "code": "173000000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Legal Medicine",
            "state": "NY",
            "license": "225253",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02300407",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Jackson Heights Social Adult Day Care
• Jackson Heights Total Chiropractic PC
• Jackson Heights Vision Associates
• Jackson Heights Vision Express LLC
• Jackson Heights Wellness Chiro P.C.
• Jackson Meds Pharmacy Inc
• Jackson Pharmacy Inc.
• Charles Jackson, DMD
• Khishigzaya Jacobs
• Jag Orthotics & Prosthetics Inc

• Legal Medicine in Jackson Heights, NY
• Providers in Jackson Heights, NY by specialty
• Legal Medicine in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 12, 2008; 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.