Organization Active NPI

Daniel Laroche, MD, PC

  • Ophthalmology Physician
  • Queens Village, NY
National Provider Identifier
1306990007
Registry record updated May 21, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ophthalmology PhysicianTaxonomy code 207W00000X
License
202107 Issued in NY
Legal business name
DANIEL LAROCHE, MD, PC
Practice address
21543 Jamaica Ave
Queens Village, NY 11428-1736
Phone
(718) 217-0424
Fax
(718) 217-0459
NPI assigned
Jan 22, 2007
Last updated
May 21, 2008By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 21, 2008

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

Authorized official

Name
Kathy Baez
Title
Coo
Phone
(516) 693-0700

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Ophthalmology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207W00000X 202107 NY Primary

Addresses

Primary practice location

21543 Jamaica Ave
Queens Village, NY 11428-1736

Mailing address

1100 Shames Dr
Suite 100
Westbury, NY 11590-1765
Phone (516) 693-0700

Other identifiers 1

IdentifierTypeStateIssuer
01749444MedicaidNY

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20080611000190 NY Part B Supplier - Clinic/Group Practice 3476624982 Receives reassigned benefits from 1 practitioner
Practice locations: New York, NY; Ozone Park, NY; Queens Village, NY

National Provider Directory

National Provider Directory

Locations

21543 Jamaica Ave
Queens Village, NY 11428
Phone (718) 217-0424

21541 Jamaica Ave
Queens Vlg, NY 11428
Phone (718) 217-0424

Practitioners & affiliated clinicians

Practitioners 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1169424000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1211328000000",
    "number": "1306990007",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1100 SHAMES DR",
            "address_2": "SUITE 100",
            "city": "WESTBURY",
            "state": "NY",
            "postal_code": "115901765",
            "telephone_number": "516-693-0700",
            "fax_number": "516-693-0271"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "21543 JAMAICA AVE",
            "city": "QUEENS VILLAGE",
            "state": "NY",
            "postal_code": "114281736",
            "telephone_number": "718-217-0424",
            "fax_number": "718-217-0459"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DANIEL LAROCHE, MD, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-22",
        "last_updated": "2008-05-21",
        "status": "A",
        "authorized_official_last_name": "BAEZ",
        "authorized_official_first_name": "KATHY",
        "authorized_official_title_or_position": "COO",
        "authorized_official_telephone_number": "516-693-0700"
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Ophthalmology",
            "state": "NY",
            "license": "202107",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01749444",
            "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 May 21, 2008; 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.