NPIMap

Organization Active NPI

Good Will Medical, P.C.

  • Family Medicine Physician
  • Far Rockaway, NY
National Provider Identifier
1245340207
Registry record updated Jun 30, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
GOOD WILL MEDICAL, P.C.
Practice address
5115 Beach Channel Dr
Far Rockaway, NY 11691-1042
Phone
(212) 563-2497
Fax
(212) 563-0605
NPI assigned
Aug 30, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 30, 2009

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

Authorized official

Name
Dr. Peter A Galvin, M.D.
Title
Director
Phone
(212) 563-2497

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207Q00000X Primary
Endocrinology, Diabetes & Metabolism PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207RE0101X

Addresses

Primary practice location

5115 Beach Channel Dr
Far Rockaway, NY 11691-1042

Mailing address

158 W 27TH St
11TH Floor South
New York, NY 10001-6216
Phone (212) 563-2497

Other identifiers 1

IdentifierTypeStateIssuer
02167279MedicaidNY

National Provider Directory

National Provider Directory

Locations

5115 Beach Channel Dr
#H
Far Rockaway, NY 11691
Phone (718) 734-3018

Practitioners & affiliated clinicians

Practitioners 17

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

View all 17

NPI Registry JSON

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

{
    "created_epoch": "1156896000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1246320000000",
    "number": "1245340207",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "158 W 27TH ST",
            "address_2": "11TH FLOOR SOUTH",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100016216",
            "telephone_number": "212-563-2497",
            "fax_number": "212-563-0605"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5115 BEACH CHANNEL DR",
            "city": "FAR ROCKAWAY",
            "state": "NY",
            "postal_code": "116911042",
            "telephone_number": "212-563-2497",
            "fax_number": "212-563-0605"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GOOD WILL MEDICAL, P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-30",
        "last_updated": "2009-06-30",
        "status": "A",
        "authorized_official_last_name": "GALVIN",
        "authorized_official_first_name": "PETER",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "212-563-2497",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "207RE0101X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine, Endocrinology, Diabetes & Metabolism",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02167279",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Far Rockaway, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 30, 2009; 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.