Pro Active Health Care PC Medical

Primary specialty

Clinic/CenterTaxonomy code 261Q00000X

License

182681 Issued in NY

Legal business name

PRO ACTIVE HEALTH CARE PC MEDICAL

Practice address

2001 Marcus Ave
Suite E240
New Hyde Park, NY 11042-1011

Phone

(516) 502-2308

Fax

(516) 673-4804

NPI assigned

Sep 3, 2008

Organization subpart

No

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

Authorized official

Name

Dr. Jocelyn Macasaet Cervantes, M.D.NPI 1700832250

Title

President

Phone

(516) 502-2308

Specialties & licenses 1

Addresses

Other names 1

• Pro Active Health Care Internal Medicine PC Doing business as

Medicare fee-for-service enrollment

Enrolled in NY

Enrollment records 1

Locations

Practitioners 1

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

• Jocelyn M. Cervantes, M.D.

  • Internal Medicine Physician
  • New Hyde Park, NY
  • NPI 1700832250
  Medicare reassignment Authorized official

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

{
    "created_epoch": "1220400000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1279152000000",
    "number": "1366690307",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2001 MARCUS AVE",
            "address_2": "SUITE E240",
            "city": "NEW HYDE PARK",
            "state": "NY",
            "postal_code": "110421011",
            "telephone_number": "516-502-2308",
            "fax_number": "516-673-4804"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2001 MARCUS AVE",
            "address_2": "SUITE E240",
            "city": "NEW HYDE PARK",
            "state": "NY",
            "postal_code": "110421011",
            "telephone_number": "516-502-2308",
            "fax_number": "516-673-4804"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PRO ACTIVE HEALTH CARE PC MEDICAL",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-09-03",
        "last_updated": "2010-07-15",
        "status": "A",
        "authorized_official_last_name": "CERVANTES",
        "authorized_official_first_name": "JOCELYN",
        "authorized_official_middle_name": "MACASAET",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "516-502-2308",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": "NY",
            "license": "182681",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Pro Active Health Care Internal Medicine PC",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Primary Care Group LLC
• Primary Partnercare Physicians PLLC
• Prime Connect Media LLC
• Princeton Neurological Institute LLC
• Douglas Louis Prisco Sr., M.D.
• Professional Occupational & Physical Therapy, PLLC
• Professional Orthopedic and Sports Physical Therapy, P.C.
• Professional Primary Care Physician PLLC
• Progressive Physical Therapy Services, PC
• Progressive Surgical Care, PLLC

• Clinic/Center in New Hyde Park, NY
• Providers in New Hyde Park, NY by specialty
• Clinic/Center in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 15, 2010; 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.