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City Medical of Upper East Side, PLLC

Organization Active NPI Urgent Care Clinic/Center · Long Beach, NY

NPI 1306284757 · NPPES record last updated Mar 3, 2025

Key facts

NPI
1306284757
Entity type
Organization (NPI type 2)
Primary specialty
Urgent Care Clinic/Center 261QU0200X
Legal business name
CITY MEDICAL OF UPPER EAST SIDE, PLLC
Practice address
904 W Beech St
Long Beach, NY 11561-1429
Phone
(516) 889-2273
NPI assigned
Jun 7, 2013
Organization subpart
Yes
Parent organization (as reported)
CITY MEDICAL OF UPPER EAST SIDE, PLLC

Authorized official

Name
Swahili Henry
Title
Director of Payment Solutions
Phone
(908) 988-0428

Corporate family (same tax ID) 24

Organizations that report the same tax identification number in the National Provider Directory.

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

Laboratory certificates & supplier records

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

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
33D2062914City Medical of Upper East Side PLLC
904 West Beech Street, Long Beach, NY 11561		Certificate of waiverMar 26, 2027

Medicare participation

Medicare fee-for-service enrollment
Enrolled in NY

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
O20101111000052 NY Part B Supplier - Clinic/Group Practice 0648465039 Receives reassigned benefits from 871 practitioners
This NPI is an additional NPI on the enrollment

National Provider Directory

Tax ID family
City Medical of Upper East Side PLLC (136 organizations share this tax ID)
Part of
City Medical of Upper East Side PLLC

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Urgent Care Clinic/Center 261QU0200X Yes

Addresses

Primary practice location

904 W Beech St
Long Beach, NY 11561-1429

Mailing address

1345 Avenue of the Americas FL 8
New York, NY 10105-0018
Phone (908) 588-3635

Other names

  • CityMD Urgent Care Doing business as

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on Mar 3, 2025.

{
    "created_epoch": "1370563200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1740960000000",
    "number": "1306284757",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1345 AVENUE OF THE AMERICAS FL 8",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "101050018",
            "telephone_number": "908-588-3635"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "904 W BEECH ST",
            "city": "LONG BEACH",
            "state": "NY",
            "postal_code": "115611429",
            "telephone_number": "516-889-2273"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CITY MEDICAL OF UPPER EAST SIDE, PLLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "CITY MEDICAL OF UPPER EAST SIDE, PLLC",
        "enumeration_date": "2013-06-07",
        "last_updated": "2025-03-03",
        "certification_date": "2025-03-03",
        "status": "A",
        "authorized_official_last_name": "HENRY",
        "authorized_official_first_name": "SWAHILI",
        "authorized_official_title_or_position": "DIRECTOR OF PAYMENT SOLUTIONS",
        "authorized_official_telephone_number": "908-988-0428"
    },
    "taxonomies": [
        {
            "code": "261QU0200X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Urgent Care",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "CityMD Urgent Care",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "CityMD Urgent Care",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Long Beach, NY

All providers in Long Beach, NY · Urgent Care Clinic/Center in New York

Sources for this page

Verify at the official NPI Registry.