Organization Active NPI

Pmy, LLC

  • Community/Retail Pharmacy
  • Staten Island, NY
National Provider Identifier
1285394940
Registry record updated Jun 3, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Retail PharmacyTaxonomy code 3336C0003X
Legal business name
PMY, LLC
Practice address
419 Forest Ave
Staten Island, NY 10301-2623
Phone
(917) 444-1588
Fax
(917) 444-1589
NPI assigned
Dec 22, 2021
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 3, 2026

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

Authorized official

Name
Abdusobirjon Utamishev
Title
Owner
Phone
(917) 444-1588

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Retail Pharmacy 3336C0003X Primary

Addresses

Primary practice location

419 Forest Ave
Staten Island, NY 10301-2623

Mailing address

419 Forest Ave
Staten Island, NY 10301-2623
Phone (917) 444-1588

Other names 1

  • XPRESSCARE PHARMACY Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20220512002758 NY DME Supplier - Pharmacy 5496132417 Practice locations: Staten Island, NY
O20221018000078 NY Part B Supplier - Pharmacy 5496132417 Practice locations: Staten Island, NY

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

Medicare medical equipment & supply locations

SupplierSuppliesMedicare assignment
Pmy, LLC419 Forest Ave, Staten Island, NY 10301-2623(917) 444-1588 Epoetin|Immunosuppressive Drugs|Infusion Drugs|Nebulizer Drugs|Oral Anticancer Drugs|Oral Antiemetic Drugs Accepts assignmentParticipating since Mar 26, 2022

National Provider Directory

National Provider Directory

Locations

419 Forest Ave
Staten Island, NY 10301
Phone (917) 444-1588

NPI Registry JSON

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

{
    "created_epoch": "1640131200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1780444800000",
    "number": "1285394940",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "419 FOREST AVE",
            "city": "STATEN ISLAND",
            "state": "NY",
            "postal_code": "103012623",
            "telephone_number": "917-444-1588",
            "fax_number": "917-444-1589"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "419 FOREST AVE",
            "city": "STATEN ISLAND",
            "state": "NY",
            "postal_code": "103012623",
            "telephone_number": "917-444-1588",
            "fax_number": "917-444-1589"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PMY, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-12-22",
        "last_updated": "2026-06-03",
        "certification_date": "2026-06-03",
        "status": "A",
        "authorized_official_last_name": "UTAMISHEV",
        "authorized_official_first_name": "ABDUSOBIRJON",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "917-444-1588"
    },
    "taxonomies": [
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "XPRESSCARE PHARMACY",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Staten Island, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 3, 2026; 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.

Verify at the official NPI Registry.