London Medical Diagnostic PC

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

Legal business name

LONDON MEDICAL DIAGNOSTIC PC

Practice address

10525 64TH Ave
Forest Hills, NY 11375-1640

Phone

(718) 459-3494

Fax

(718) 606-6069

NPI assigned

Aug 18, 2008

Organization subpart

No

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

Authorized official

Name

Dr. Ilya Y Burshteyn, MDNPI 1073546131

Title

MD/Ceo

Phone

(718) 459-3494

Specialties & licenses 7

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in NY

Enrollment records 1

Locations

Practitioners 4

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

• Ilya Y Burshteyn, MD

  • General Practice Physician
  • Forest Hills, NY
  • NPI 1073546131
  Medicare reassignment Care Compare group Authorized official
• David Paul Nupp, PT

  • Physical Therapist
  • Bayside, NY
  • NPI 1548255789
  Medicare reassignment Care Compare group NPD
• Sabine Edeline Larosiliere, DPM

  • Podiatrist
  • Bronx, NY
  • NPI 1215964606
  Medicare reassignment Care Compare group
• Sofya Bababekova, FNP-C

  • Family Nurse Practitioner
  • Forest Hills, NY
  • NPI 1871201202
  NPD

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

{
    "created_epoch": "1219017600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1687132800000",
    "number": "1407002702",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10525 64TH AVE",
            "city": "FOREST HILLS",
            "state": "NY",
            "postal_code": "113751640",
            "telephone_number": "718-459-3494",
            "fax_number": "718-606-6069"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10525 64TH AVE",
            "city": "FOREST HILLS",
            "state": "NY",
            "postal_code": "113751640",
            "telephone_number": "718-459-3494",
            "fax_number": "718-606-6069"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1401 Ocean Ave Ste LD",
            "address_purpose": "LOCATION",
            "city": "Brooklyn",
            "state": "NY",
            "postal_code": "112303998",
            "country_code": "US",
            "telephone_number": "718-513-4455",
            "fax_number": "718-375-1944",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "LONDON MEDICAL DIAGNOSTIC PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-08-18",
        "last_updated": "2023-06-19",
        "certification_date": "2023-06-19",
        "status": "A",
        "authorized_official_last_name": "BURSHTEYN",
        "authorized_official_first_name": "ILYA",
        "authorized_official_middle_name": "Y",
        "authorized_official_title_or_position": "MD/CEO",
        "authorized_official_telephone_number": "718-459-3494",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Specialist",
            "state": "NY",
            "license": "215638",
            "primary": false
        },
        {
            "code": "174400000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Specialist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "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": "363AM0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physician Assistant, Medical",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner, Family",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "03272777",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Logistics Medical Associates PC
• Judy Lokenauth-Parangan, FNP-C
• David Lomasney
• Annamaria Lombardi, DPT
• Rose A Lombardo, M.D.
• Jorge Albeiro Londono Lenis
• Long Island Geriatric Psychological Services P.C.
• Long Island Queens Hearing Asso Inc
• Tara Ann Longo, NP
• Shirah Lonshein, OTR/L

• Internal Medicine Physician in Forest Hills, NY
• Providers in Forest Hills, 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 Jun 19, 2023; 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.