Complete Care Medical of N.Y. P.C.

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

Legal business name

COMPLETE CARE MEDICAL OF N.Y. P.C.

Practice address

311 Saint Nicholas Ave Ste E
Ridgewood, NY 11385-2296

Phone

(718) 894-2500

Fax

(718) 417-4535

NPI assigned

Dec 3, 2010

Organization subpart

No

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

Authorized official

Name

Mr. Mariano Mederos, M.D.NPI 1598743007

Title

M.D.

Phone

(718) 894-2500

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in NY

Enrollment records 1

Practitioners 1

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

• Mariano Mederos, M.D

  • Internal Medicine Physician
  • Ridgewood, NY
  • NPI 1598743007
  Medicare reassignment Authorized official

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

{
    "created_epoch": "1291334400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1465171200000",
    "number": "1346542818",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "311 SAINT NICHOLAS AVE STE E",
            "city": "RIDGEWOOD",
            "state": "NY",
            "postal_code": "113852296",
            "telephone_number": "718-894-2500",
            "fax_number": "718-417-4535"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "311 SAINT NICHOLAS AVE STE E",
            "city": "RIDGEWOOD",
            "state": "NY",
            "postal_code": "113852296",
            "telephone_number": "718-894-2500",
            "fax_number": "718-417-4535"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COMPLETE CARE MEDICAL OF N.Y. P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-12-03",
        "last_updated": "2016-06-06",
        "status": "A",
        "authorized_official_last_name": "MEDEROS",
        "authorized_official_first_name": "MARIANO",
        "authorized_official_title_or_position": "M.D.",
        "authorized_official_telephone_number": "718-894-2500",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00947791",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Gary Cohen
• Ilan Cohen, MD
• Elena Cojocaru, NP
• Doina Coman, DDS
• Giovanni Como Jr., PHARMD
• Courtney Cookman, LCSW
• Kaitlynn B. Cornell-Mullane, LCAT, RDT, MA
• Catherine Mary Corrigan, ANP
• Sandra Catalina Cortes, SA-C
• Doris Corujo, RN

• Internal Medicine Physician in Ridgewood, NY
• Providers in Ridgewood, NY by specialty
• Internal Medicine Physician in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 6, 2016; 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.