NPIMap

Organization Active NPI

Hollis Ak LLC

Doing business as HealthMed Diagnostic & Treatment Center

  • Multi-Specialty Clinic/Center
  • Jamaica, NY
National Provider Identifier
1295454650
Registry record updated Nov 6, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Multi-Specialty Clinic/CenterTaxonomy code 261QM1300X
Legal business name
HOLLIS AK LLC
Doing business as
HealthMed Diagnostic & Treatment Center
Practice address
19002 Jamaica Ave
Jamaica, NY 11423-2034
Phone
(718) 577-2211
Fax
(929) 399-7959
NPI assigned
Aug 26, 2022
Last updated
Nov 6, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 6, 2023

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

Authorized official

Name
Ari Kalontarov
Title
President
Phone
(347) 245-2279

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Multi-Specialty Clinic/Center 261QM1300X Primary

Addresses

Primary practice location

19002 Jamaica Ave
Jamaica, NY 11423-2034

Mailing address

19002 Jamaica Ave
Jamaica, NY 11423-2034
Phone (718) 577-2211

Other names 1

  • HealthMed Diagnostic & Treatment Center Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20221230001544 NY Part B Supplier - Clinic/Group Practice 6901276260 Receives reassigned benefits from 16 practitioners
Practice locations: Hollis, NY

National Provider Directory

National Provider Directory

Locations

19002 Jamaica Ave
Jamaica, NY 11423
Phone (718) 417-0207

Practitioners & affiliated clinicians

Practitioners 17

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 17

NPI Registry JSON

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

{
    "created_epoch": "1661472000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1699228800000",
    "number": "1295454650",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "19002 JAMAICA AVE",
            "city": "JAMAICA",
            "state": "NY",
            "postal_code": "114232034",
            "telephone_number": "718-577-2211",
            "fax_number": "929-399-7959"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "19002 JAMAICA AVE",
            "city": "JAMAICA",
            "state": "NY",
            "postal_code": "114232034",
            "telephone_number": "718-577-2211",
            "fax_number": "929-399-7959"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HOLLIS AK LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-08-26",
        "last_updated": "2023-11-06",
        "certification_date": "2022-09-05",
        "status": "A",
        "authorized_official_last_name": "KALONTAROV",
        "authorized_official_first_name": "ARI",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "347-245-2279"
    },
    "taxonomies": [
        {
            "code": "261QM1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Multi-Specialty",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "HealthMed Diagnostic & Treatment Center",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "HealthMed Diagnostic & Treatment Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Jamaica, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 6, 2023; 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.