Individual provider Active NPI

Carmencita Razo Ulep, M.D.

  • General Practice Physician
  • Queens Village, NY
National Provider Identifier
1295921443
Registry record updated Sep 21, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice PhysicianTaxonomy code 208D00000X
License
166052 Issued in NY
Practice address
9245 Winchester Blvd
Queens Village, NY 11428-1871
Phone
(917) 597-3418
Fax
(718) 479-4567
NPI assigned
Sep 21, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 21, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Physician 208D00000X 166052 NY Primary

Addresses

Primary practice location

9245 Winchester Blvd
Queens Village, NY 11428-1871

Mailing address

9245 Winchester Blvd
Queens Village, NY 11428-1871
Phone (917) 597-3418

Other identifiers 1

IdentifierTypeStateIssuer
02816122MedicaidNY

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
166052NYMDGeneral Practice Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Empress Ambulance Service LLC Past Accepting new patients
Lifespire, Inc. Past Accepting new patients
Lifespire, Inc. Past Accepting new patients

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1190332800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1190332800000",
    "number": "1295921443",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9245 WINCHESTER BLVD",
            "city": "QUEENS VILLAGE",
            "state": "NY",
            "postal_code": "114281871",
            "telephone_number": "917-597-3418",
            "fax_number": "718-479-4567"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9245 WINCHESTER BLVD",
            "city": "QUEENS VILLAGE",
            "state": "NY",
            "postal_code": "114281871",
            "telephone_number": "917-597-3418",
            "fax_number": "718-479-4567"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ULEP",
        "first_name": "CARMENCITA",
        "middle_name": "RAZO",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-09-21",
        "last_updated": "2007-09-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "NY",
            "license": "166052",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02816122",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Queens Village, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 21, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.