Organization Active NPI

Queens Medical Care PC

  • Internal Medicine Physician
  • Jamaica, NY
National Provider Identifier
1316094972
Registry record updated Oct 31, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
211588 Issued in NY
Legal business name
QUEENS MEDICAL CARE PC
Practice address
87-42 169TH Street
Jamaica, NY 11432
Phone
(718) 206-2222
Fax
(718) 206-9090
NPI assigned
Jan 5, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 31, 2012

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

Authorized official

Name
Naheed Sultana, M.D.NPI 1679580948
Title
Physician-Owner
Phone
(718) 206-2222

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207R00000X 211588 NY Primary

Addresses

Primary practice location

87-42 169TH Street
Jamaica, NY 11432

Mailing address

87-42 169TH Street
Jamaica, NY 11432
Phone (718) 206-2222

Other identifiers 1

IdentifierTypeStateIssuer
02282084MedicaidNY

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20041001001043 NY Part B Supplier - Clinic/Group Practice 6709777568 Receives reassigned benefits from 1 practitioner
Practice locations: Jamaica, NY

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

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": "1167955200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1351641600000",
    "number": "1316094972",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "87-42 169TH STREET",
            "city": "JAMAICA",
            "state": "NY",
            "postal_code": "11432",
            "telephone_number": "718-206-2222",
            "fax_number": "718-206-9090"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "87-42 169TH STREET",
            "city": "JAMAICA",
            "state": "NY",
            "postal_code": "11432",
            "telephone_number": "718-206-2222",
            "fax_number": "718-206-9090"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "QUEENS MEDICAL CARE PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-05",
        "last_updated": "2012-10-31",
        "status": "A",
        "authorized_official_last_name": "SULTANA",
        "authorized_official_first_name": "NAHEED",
        "authorized_official_title_or_position": "PHYSICIAN-OWNER",
        "authorized_official_telephone_number": "718-206-2222",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine",
            "state": "NY",
            "license": "211588",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02282084",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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 Oct 31, 2012; 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.