Organization Active NPI

Q-Care Affordable Medical Care, PLLC

  • Family Medicine Physician
  • Elmhurst, NY
National Provider Identifier
1447480439
Registry record updated Apr 25, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
221293 Issued in NY
Legal business name
Q-CARE AFFORDABLE MEDICAL CARE, PLLC
Practice address
4150 78TH St
Suite 102/103
Elmhurst, NY 11373-1950
Phone
(718) 606-0187
Fax
(718) 606-0958
NPI assigned
Jul 23, 2009
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 25, 2011

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

Authorized official

Name
Dr. Kevin Alexander Charlotten, MDNPI 1538143433
Title
Principal
Phone
(718) 606-0187

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 PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207Q00000X 221293 NY Primary

Addresses

Primary practice location

4150 78TH St
Suite 102/103
Elmhurst, NY 11373-1950

Mailing address

4150 78TH St
Suite #102/103
Elmhurst, NY 11373-1950
Phone (718) 606-0187

Other identifiers 1

IdentifierTypeStateIssuer
02230353MedicaidNY

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20090826000256 NY Part B Supplier - Clinic/Group Practice 8123173275 Receives reassigned benefits from 2 practitioners
Practice locations: Elmhurst, NY

National Provider Directory

National Provider Directory

Locations

4150 78th St
Ste 102103
Elmhurst, NY 11373
Phone (718) 606-0187

4150 78th St
Ste 102
Elmhurst, NY 11373

4150 78th St
Flushing, NY 11373
Phone (718) 570-6565

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/FGEHAA

Practitioners & affiliated clinicians

Practitioners 2

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": "1248307200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1303689600000",
    "number": "1447480439",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4150 78TH ST",
            "address_2": "SUITE #102/103",
            "city": "ELMHURST",
            "state": "NY",
            "postal_code": "113731950",
            "telephone_number": "718-606-0187",
            "fax_number": "718-606-0958"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4150 78TH ST",
            "address_2": "SUITE 102/103",
            "city": "ELMHURST",
            "state": "NY",
            "postal_code": "113731950",
            "telephone_number": "718-606-0187",
            "fax_number": "718-606-0958"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "Q-CARE AFFORDABLE MEDICAL CARE, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-07-23",
        "last_updated": "2011-04-25",
        "status": "A",
        "authorized_official_last_name": "CHARLOTTEN",
        "authorized_official_first_name": "KEVIN",
        "authorized_official_middle_name": "ALEXANDER",
        "authorized_official_title_or_position": "PRINCIPAL",
        "authorized_official_telephone_number": "718-606-0187",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": "NY",
            "license": "221293",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02230353",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Elmhurst, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 25, 2011; 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.