NPIMap

Organization Active NPI

Dr Philip R.Baldeo Medical Services,PC

  • Family Medicine Physician
  • Queens, NY
National Provider Identifier
1427337393
Registry record updated Mar 27, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
DR PHILIP R.BALDEO MEDICAL SERVICES,PC
Practice address
12507 Liberty Ave
South Richmond Hill
Queens, NY 11419-2233
Phone
(718) 845-8900
Fax
(866) 372-8750
NPI assigned
Aug 10, 2011
Last updated
Mar 27, 2017By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 27, 2017

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

Authorized official

Name
Philip R Baldeo, MDNPI 1003992033
Title
Director
Phone
(718) 845-8900

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
Family Medicine Physician 207Q00000X NU Primary

Addresses

Primary practice location

12507 Liberty Ave
South Richmond Hill
Queens, NY 11419-2233

Mailing address

125-07 Liberty Ave
South Richmond Hill
Queens, NY 11419
Phone (718) 845-8900

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20111012000402 NY Part B Supplier - Clinic/Group Practice 6103098397 Receives reassigned benefits from 10 practitioners
Practice locations: Monroe, NY; South Richmond Hill, NY

National Provider Directory

National Provider Directory
Tax ID family
Dr Philip Rbaldeo Medical Servicespc2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Locations

491 State Route 208
Ste 104
Monroe, NY 10950
Phone (718) 845-8900

Practitioners & affiliated clinicians

Practitioners 11

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": "1312934400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1490572800000",
    "number": "1427337393",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "125-07 LIBERTY AVE",
            "address_2": "SOUTH RICHMOND HILL",
            "city": "QUEENS",
            "state": "NY",
            "postal_code": "11419",
            "telephone_number": "718-845-8900",
            "fax_number": "866-372-8750"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12507 LIBERTY AVE",
            "address_2": "SOUTH RICHMOND HILL",
            "city": "QUEENS",
            "state": "NY",
            "postal_code": "114192233",
            "telephone_number": "718-845-8900",
            "fax_number": "866-372-8750"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DR PHILIP R.BALDEO MEDICAL SERVICES,PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-08-10",
        "last_updated": "2017-03-27",
        "status": "A",
        "authorized_official_last_name": "BALDEO",
        "authorized_official_first_name": "PHILIP",
        "authorized_official_middle_name": "R",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "718-845-8900",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Queens, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 27, 2017; 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.