Individual provider Active NPI

Oscar D Pagalilauan, MD

  • Internal Medicine Physician
  • Ridgewood, NY
National Provider Identifier
1366518177
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
121687 Issued in NY
Practice address
321 Wyckoff Avenue
Ridgewood, NY 11385
Phone
(718) 386-3288
Fax
(718) 386-3540
NPI assigned
Nov 27, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 121687 NY Primary

Addresses

Primary practice location

321 Wyckoff Avenue
Ridgewood, NY 11385

Mailing address

1 Bellwood Drive
New Hyde Park, NY 11040

Other identifiers 3

IdentifierTypeStateIssuer
00228524MedicaidNY
70A58OtherNYEMPIRE BLUE CROSS BLUE SH
0076835OtherNYGHI

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
121687NYMDInternal Medicine Physician

NPI Registry JSON

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

{
    "created_epoch": "1164585600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1366518177",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 BELLWOOD DRIVE",
            "city": "NEW HYDE PARK",
            "state": "NY",
            "postal_code": "11040"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "321 WYCKOFF AVENUE",
            "city": "RIDGEWOOD",
            "state": "NY",
            "postal_code": "11385",
            "telephone_number": "718-386-3288",
            "fax_number": "718-386-3540"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PAGALILAUAN",
        "first_name": "OSCAR",
        "middle_name": "D",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-11-27",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NY",
            "license": "121687",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00228524",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "EMPIRE BLUE CROSS BLUE SH",
            "identifier": "70A58",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GHI",
            "identifier": "0076835",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Ridgewood, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.