Organization Active NPI

Multimedic Medical Services PLLC

  • Pulmonary Disease Physician
  • Bronx, NY
National Provider Identifier
1376806380
Registry record updated Oct 2, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pulmonary Disease PhysicianTaxonomy code 207RP1001X
License
186141 Issued in NY
Legal business name
MULTIMEDIC MEDICAL SERVICES PLLC
Practice address
1070 Southern Blvd
Bronx, NY 10459-3268
Phone
(347) 242-4436
NPI assigned
Jun 25, 2012
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 2, 2015

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

Authorized official

Name
Samuel Deleon, MDNPI 1770589111
Title
President
Phone
(347) 242-4436

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pulmonary Disease PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207RP1001X 186141 NY Primary

Addresses

Primary practice location

1070 Southern Blvd
Bronx, NY 10459-3268

Mailing address

96 Linwood PLZ # 410
Fort Lee, NJ 07024-3701
Phone (347) 242-4436

Other identifiers 1

IdentifierTypeStateIssuer
82K211OtherMEDICARE

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20130206000086 NY Part B Supplier - Clinic/Group Practice 8820242555 Receives reassigned benefits from 1 practitioner
Practice locations: Bronx, NY

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

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

NPI Registry JSON

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

{
    "created_epoch": "1340582400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1443744000000",
    "number": "1376806380",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "96 LINWOOD PLZ # 410",
            "city": "FORT LEE",
            "state": "NJ",
            "postal_code": "070243701",
            "telephone_number": "347-242-4436"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1070 SOUTHERN BLVD",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "104593268",
            "telephone_number": "347-242-4436"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MULTIMEDIC MEDICAL SERVICES PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-06-25",
        "last_updated": "2015-10-02",
        "status": "A",
        "authorized_official_last_name": "DELEON",
        "authorized_official_first_name": "SAMUEL",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "347-242-4436",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207RP1001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine, Pulmonary Disease",
            "state": "NY",
            "license": "186141",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE",
            "identifier": "82K211",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Bronx, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 2, 2015; 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.