Intermed Care PC

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

Legal business name

INTERMED CARE PC

Practice address

55 E 124TH St
New York, NY 10035-1815

Phone

(646) 895-9118

NPI assigned

Aug 22, 2011

Organization subpart

No

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

Authorized official

Name

Boris Mazurov, MD

Title

Medical Director

Phone

(718) 331-9600

Specialties & licenses 4

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in NY

Enrollment records 1

Other NPIs on the same Medicare enrollment 2

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

• Intermed Care PC

  • Internal Medicine Physician
  • Brooklyn, NY
  • NPI 1063792158

  O20040315000371

  Same enrollment
• Intermed Care PC

  • Legal Medicine
  • Brooklyn, NY
  • NPI 1144235516

  O20040315000371

  Same enrollment

Locations

Practitioners 1

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.

• David Khasidy, M.D.

  • Internal Medicine Physician
  • Brooklyn, NY
  • NPI 1417995358
  NPD

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

{
    "created_epoch": "1313971200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1316131200000",
    "number": "1356621445",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1849 86TH ST",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112143108",
            "telephone_number": "718-331-9600",
            "fax_number": "718-331-9703"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "55 E 124TH ST",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100351815",
            "telephone_number": "646-895-9118"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "INTERMED CARE PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-08-22",
        "last_updated": "2011-09-16",
        "status": "A",
        "authorized_official_last_name": "MAZUROV",
        "authorized_official_first_name": "BORIS",
        "authorized_official_title_or_position": "MEDICAL DIRECTOR",
        "authorized_official_telephone_number": "718-331-9600",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "213E00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Podiatrist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "225X00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Occupational Therapist",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "03324018",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Intergral Medical Health Wellness PLLC
• Internal Medical Care Associates
• International Center for the Disabled
• International Center for the Disabled
• International Center of Hope
• International Cosmetic Surgery

• Internal Medicine Physician in New York, NY
• Providers in New York, 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 Sep 16, 2011; 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.