NPIMap

Organization Active NPI

Fatima Pediatric Medical Care PC

  • Legal Medicine
  • Astoria, NY
National Provider Identifier
1295896744
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Legal MedicineTaxonomy code 173000000X
License
200364 Issued in NY
Legal business name
FATIMA PEDIATRIC MEDICAL CARE PC
Practice address
2552 Steinway St
Astoria, NY 11103-3759
Phone
(718) 777-6695
NPI assigned
Dec 12, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Mohyuddin M Qureshi
Title
Sole Proprietor
Phone
(718) 777-6695

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Legal MedicineGroup: 193400000X SINGLE SPECIALTY GROUP 173000000X 200364 NY Primary

Addresses

Primary practice location

2552 Steinway St
Astoria, NY 11103-3759

Mailing address

2552 Steinway St
Astoria, NY 11103-3759
Phone (718) 777-6695

Other identifiers 1

IdentifierTypeStateIssuer
01583311MedicaidNY

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20120627000622 NY Part B Supplier - Clinic/Group Practice 3577728419 Receives reassigned benefits from 11 practitioners
Practice locations: Astoria, NY

National Provider Directory

National Provider Directory

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/AHAGBA

Practitioners & affiliated clinicians

Practitioners 11

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": "1165881600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1295896744",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2552 STEINWAY ST",
            "city": "ASTORIA",
            "state": "NY",
            "postal_code": "111033759",
            "telephone_number": "718-777-6695"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2552 STEINWAY ST",
            "city": "ASTORIA",
            "state": "NY",
            "postal_code": "111033759",
            "telephone_number": "718-777-6695"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FATIMA PEDIATRIC MEDICAL CARE PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-12",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "QURESHI",
        "authorized_official_first_name": "MOHYUDDIN",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "SOLE PROPRIETOR",
        "authorized_official_telephone_number": "718-777-6695"
    },
    "taxonomies": [
        {
            "code": "173000000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Legal Medicine",
            "state": "NY",
            "license": "200364",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01583311",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Astoria, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 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.