Organization Active NPI

Cross Island Medical LLC

  • Internal Medicine Physician
  • Howard Beach, NY
National Provider Identifier
1285290775
Registry record updated Jun 4, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
Legal business name
CROSS ISLAND MEDICAL LLC
Practice address
13525 79TH St
Howard Beach, NY 11414-1010
Phone
(917) 903-3885
NPI assigned
May 10, 2019
Last updated
Jun 4, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 4, 2020

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

Authorized official

Name
Himanshu Pandya, MDNPI 1003896929
Title
President
Phone
(917) 903-3885

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 2

Specialty (taxonomy)CodeLicenseStatePrimary
Urgent Care Clinic/Center 261QU0200X NU
Internal Medicine Physician 207R00000X NU Primary

Addresses

Primary practice location

13525 79TH St
Howard Beach, NY 11414-1010

Mailing address

13525 79TH St
Howard Beach, NY 11414-1010
Phone (917) 903-3885

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20200629000471 NY Part B Supplier - Clinic/Group Practice 0547682114 Receives reassigned benefits from 19 practitioners
Practice locations: Brooklyn, NY; Hicksville, NY; Howard Beach, NY; Jackson Heights, NY; Queens Village, NY

National Provider Directory

National Provider Directory

Locations

7322 5th Ave
Brooklyn, NY 11209
Phone (718) 333-5120

23315 Hillside Ave
Queens Vlg, NY 11427
Phone (718) 210-1945

Practitioners & affiliated clinicians

Practitioners 21

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 21

NPI Registry JSON

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

{
    "created_epoch": "1557446400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1591228800000",
    "number": "1285290775",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13525 79TH ST",
            "city": "HOWARD BEACH",
            "state": "NY",
            "postal_code": "114141010",
            "telephone_number": "917-903-3885"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13525 79TH ST",
            "city": "HOWARD BEACH",
            "state": "NY",
            "postal_code": "114141010",
            "telephone_number": "917-903-3885"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CROSS ISLAND MEDICAL LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-05-10",
        "last_updated": "2020-06-04",
        "certification_date": "2020-06-04",
        "status": "A",
        "authorized_official_last_name": "PANDYA",
        "authorized_official_first_name": "HIMANSHU",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "917-903-3885",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "261QU0200X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Urgent Care",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Howard Beach, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 4, 2020; 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.