NPIMap

Organization Active NPI

Kezmed Medical PC

  • Cardiovascular Disease Physician
  • Dix Hills, NY
National Provider Identifier
1366871378
Registry record updated Nov 11, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Cardiovascular Disease PhysicianTaxonomy code 207RC0000X
License
262198-1 Issued in NY
Legal business name
KEZMED MEDICAL PC
Practice address
42 Woods End Rd N
Dix Hills, NY 11746-5934
Phone
(347) 860-1900
NPI assigned
Nov 11, 2013
Last updated
Nov 11, 2013By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 11, 2013

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

Authorized official

Name
Andrew Ormson
Title
Credentialer
Phone
(917) 945-5436

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Cardiovascular Disease Physician 207RC0000X 262198-1 NY Primary

Addresses

Primary practice location

42 Woods End Rd N
Dix Hills, NY 11746-5934

Mailing address

228 Park Ave S
#36910
New York, NY 10003-1502
Phone (347) 860-1900

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20140613000651 NY Part B Supplier - Clinic/Group Practice 4688898687 Receives reassigned benefits from 5 practitioners
Practice locations: Bronx, NY; New York, NY

National Provider Directory

National Provider Directory

Locations

2510 Westchester Ave
Ste 208
Bronx, NY 10461
Phone (646) 530-8447

Practitioners & affiliated clinicians

Practitioners 6

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.

NPI Registry JSON

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

{
    "created_epoch": "1384128000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1384128000000",
    "number": "1366871378",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "228 PARK AVE S",
            "address_2": "#36910",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100031502",
            "telephone_number": "347-860-1900"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "42 WOODS END RD N",
            "city": "DIX HILLS",
            "state": "NY",
            "postal_code": "117465934",
            "telephone_number": "347-860-1900"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KEZMED MEDICAL PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-11-11",
        "last_updated": "2013-11-11",
        "status": "A",
        "authorized_official_last_name": "ORMSON",
        "authorized_official_first_name": "ANDREW",
        "authorized_official_title_or_position": "CREDENTIALER",
        "authorized_official_telephone_number": "917-945-5436"
    },
    "taxonomies": [
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "NY",
            "license": "262198-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Dix Hills, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 11, 2013; 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.