Individual provider Active NPI

Pedro A Corzo, M.D.

  • Internal Medicine Physician
  • Corona, NY
National Provider Identifier
1275699852
Registry record updated Apr 12, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
191262 Issued in NY
Practice address
10308 Roosevelt Ave
Corona, NY 11368-2330
Phone
(718) 205-4065
Fax
(718) 205-4053
NPI assigned
Dec 28, 2006
Last updated
Apr 12, 2022By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 12, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 191262 NY Primary

Addresses

Primary practice location

10308 Roosevelt Ave
Corona, NY 11368-2330

Mailing address

60 Dogwood Ave
Roslyn, NY 11576-1204
Phone (516) 621-0086

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040726001023 NY Practitioner - Internal Medicine 7719957000 Reassigns benefits to 1 organization
Practice locations: Corona, NY

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 1985
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

10418 Roosevelt Ave
Corona, NY 11368-2328

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
191262NYMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
PA Corzo Medical PLLC Internal Medicine CurrentSince Jun 1, 2025 Accepting new patients
Dental & Family Medical Center Past Accepting new patients
Caledonian Health Center PastSince Dec 1, 2004 Accepting new patients
TBHC Medical Services PC Past Accepting new patients

Locations

10418 Roosevelt Ave
#1
Corona, NY 11368
Phone (718) 205-4065

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 5

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1167264000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1649721600000",
    "number": "1275699852",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "60 DOGWOOD AVE",
            "city": "ROSLYN",
            "state": "NY",
            "postal_code": "115761204",
            "telephone_number": "516-621-0086",
            "fax_number": "718-205-4053"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10308 ROOSEVELT AVE",
            "city": "CORONA",
            "state": "NY",
            "postal_code": "113682330",
            "telephone_number": "718-205-4065",
            "fax_number": "718-205-4053"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CORZO",
        "first_name": "PEDRO",
        "middle_name": "A",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-12-28",
        "last_updated": "2022-04-12",
        "certification_date": "2022-04-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NY",
            "license": "191262",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Corona, NY

Sources for this page

Verify at the official NPI Registry.