Active NPI
Simon Lipetz MD. P.C
- Legal Medicine
- Forest Hills, NY
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Legal Medicine
- License
- 186190
- Legal business name
- SIMON LIPETZ MD. P.C
- Practice address
- 104-60 Queens Blvd
Suite CH
Forest Hills, NY 11375 - Phone
- (718) 275-4849
- Fax
- (718) 275-6381
- NPI assigned
- Jul 12, 2007
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Simon Lipetz
- Title
- Owner
- Phone
- (718) 275-4849
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 4
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Legal Medicine | 173000000X | 186190 | NY | Primary |
| Legal Medicine | 173000000X | 107463 | NY | |
| Legal Medicine | 173000000X | 458751 | NY | |
| Internal Medicine Physician | 207R00000X |
Addresses
Primary practice location
104-60 Queens Blvd
Suite CH
Forest Hills, NY 11375
Mailing address
104-60 Queens Blvd.
Suite CH
Forest Hills, NY 11375
Phone (718) 275-4849
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in NY
Enrollment records 1
Laboratory certificates & supplier records
Derived by NPIMapThese CMS records do not include an NPI. They are shown because their name and street address match this provider’s.
CLIA laboratory certificates
| CLIA number | Laboratory | Certificate | Expires |
|---|---|---|---|
| 33D0865466 | Simon Lipetz MD PC | Certificate of waiver | Aug 31, 2026 |
National Provider Directory
National Provider DirectoryPractitioners & affiliated clinicians
Practitioners 4
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.
-
- Internal Medicine Physician
- Forest Hills, NY
- NPI 1710967393
-
- Diagnostic Radiology Physician
- Brooklyn, NY
- NPI 1891746517
-
- Diagnostic Radiology Physician
- Vineland, NJ
- NPI 1518906726
NY, Single Specialty
-
- Diagnostic Radiology Physician
- Yonkers, NY
- NPI 1144325978
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1184198400000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1405382400000",
"number": "1235338138",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "104-60 QUEENS BLVD.",
"address_2": "SUITE CH",
"city": "FOREST HILLS",
"state": "NY",
"postal_code": "11375",
"telephone_number": "718-275-4849",
"fax_number": "718-275-6381"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "104-60 QUEENS BLVD",
"address_2": "SUITE CH",
"city": "FOREST HILLS",
"state": "NY",
"postal_code": "11375",
"telephone_number": "718-275-4849",
"fax_number": "718-275-6381"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "SIMON LIPETZ MD. P.C",
"organizational_subpart": "NO",
"enumeration_date": "2007-07-12",
"last_updated": "2014-07-15",
"status": "A",
"authorized_official_last_name": "LIPETZ",
"authorized_official_first_name": "SIMON",
"authorized_official_title_or_position": "OWNER",
"authorized_official_telephone_number": "718-275-4849"
},
"taxonomies": [
{
"code": "173000000X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Legal Medicine",
"state": "NY",
"license": "186190",
"primary": true
},
{
"code": "173000000X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Legal Medicine",
"state": "NY",
"license": "107463",
"primary": false
},
{
"code": "173000000X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Legal Medicine",
"state": "NY",
"license": "458751",
"primary": false
},
{
"code": "207R00000X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Internal Medicine",
"state": null,
"license": null,
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Forest Hills, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 15, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.