St. Petersburg Medical Care LLC

Primary specialty

Gynecology PhysicianTaxonomy code 207VG0400X

License

202334 Issued in NY

Legal business name

ST. PETERSBURG MEDICAL CARE LLC

Practice address

225 East Ave
Lockport, NY 14094-3812

Phone

(716) 438-3546

NPI assigned

Oct 10, 2016

Organization subpart

No

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

Authorized official

Name

Dr. Mohamed Khalaf, MDNPI 1528004595

Title

Manager

Phone

(716) 438-3546

Specialties & licenses 2

Addresses

Other identifiers 1

Locations

Practitioners 1

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

• Mohamed Abdel Hakeem Khalaf, MD

  • Family Medicine Physician
  • Clearwater Beach, FL
  • NPI 1528004595
  NPD (past) Authorized official

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

{
    "created_epoch": "1476057600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1476057600000",
    "number": "1437609807",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2001 16TH ST N",
            "address_2": "ATTN:PAUL C JENSEN",
            "city": "ST PETERSBURG",
            "state": "FL",
            "postal_code": "337043921",
            "telephone_number": "716-438-3546"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "225 EAST AVE",
            "city": "LOCKPORT",
            "state": "NY",
            "postal_code": "140943812",
            "telephone_number": "716-438-3546"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ST. PETERSBURG MEDICAL CARE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-10-10",
        "last_updated": "2016-10-10",
        "status": "A",
        "authorized_official_last_name": "KHALAF",
        "authorized_official_first_name": "MOHAMED",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "716-438-3546",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": "NY",
            "license": "202334",
            "primary": false
        },
        {
            "code": "207VG0400X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Obstetrics & Gynecology, Gynecology",
            "state": "NY",
            "license": "202334",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01636066",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Christopher Somsook, DO
• South Lockport Fire Company, Inc.
• South Street Health Services Family Health and Psychiatry NPS PLLC
• Christopher Charles Sova, PHD
• Nancy Michele St Laurent, LPN
• Corey Alexander Stack, PA
• Bonnie Lynn Stafford
• Heather Staggers
• Sherrie Stahl, M.S., C.A.S.
• Emily Staniszewski

• Gynecology Physician in Lockport, NY
• Providers in Lockport, NY by specialty
• Gynecology Physician in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 10, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.