Organization Active NPI

Northern Medical Care PC

  • Clinic/Center
  • Corona, NY
National Provider Identifier
1275916652
Registry record updated Apr 29, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinic/CenterTaxonomy code 261Q00000X
Legal business name
NORTHERN MEDICAL CARE PC
Practice address
10520 Northern Blvd
Corona, NY 11368-1133
Phone
(347) 808-0346
NPI assigned
Jul 3, 2015
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 29, 2021

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

Authorized official

Name
Omar AhmedNPI 1831517002
Title
President
Phone
(347) 808-0346

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 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinic/Center 261Q00000X Primary

Addresses

Primary practice location

10520 Northern Blvd
Corona, NY 11368-1133

Mailing address

10520 Northern Blvd
Corona, NY 11368-1133
Phone (347) 808-0346

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20160627000501 NY Part B Supplier - Clinic/Group Practice 5597056382 Receives reassigned benefits from 5 practitioners
Practice locations: Brooklyn, NY; Forest Hills, NY; New York, NY; Roslyn Heights, NY

National Provider Directory

National Provider Directory

Locations

1150 Webster Ave
Ste 4
Bronx, NY 10456
Phone (347) 271-5338

10520 Northern Blvd
Corona, NY 11368
Phone (347) 808-0346

Practitioners & affiliated clinicians

Practitioners 6

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": "1435881600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1619654400000",
    "number": "1275916652",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10520 NORTHERN BLVD",
            "city": "CORONA",
            "state": "NY",
            "postal_code": "113681133",
            "telephone_number": "347-808-0346"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10520 NORTHERN BLVD",
            "city": "CORONA",
            "state": "NY",
            "postal_code": "113681133",
            "telephone_number": "347-808-0346"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NORTHERN MEDICAL CARE PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-07-03",
        "last_updated": "2021-04-29",
        "certification_date": "2021-04-29",
        "status": "A",
        "authorized_official_last_name": "AHMED",
        "authorized_official_first_name": "OMAR",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "347-808-0346"
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Corona, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 29, 2021; 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.