United Medical Diagnostic Services P.C.

Primary specialty

Physical Medicine & Rehabilitation PhysicianTaxonomy code 208100000X

License

211676 Issued in NY

Legal business name

UNITED MEDICAL DIAGNOSTIC SERVICES P.C.

Practice address

1021 Fordham LN
Woodmere, NY 11598-1013

Phone

(516) 791-5750

NPI assigned

Aug 30, 2006

Last updated

Aug 22, 2020By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Teymuraz DatikashviliNPI 1952353161

Title

MD

Phone

(516) 791-5750

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in NY

Enrollment records 1

Locations

Practitioners 6

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.

• Teymuraz Datikashvili, M.D.

  • Physical Medicine & Rehabilitation Physician
  • Forest Hills, NY
  • NPI 1952353161
  Medicare reassignment NPD Authorized official
• Sobha D Gavani, M.D.

  • Cardiovascular Disease Physician
  • Yonkers, NY
  • NPI 1467528117
  NPD (past)
• Hyoseong Kim, LAC

  • Acupuncturist
  • Flushing, NY
  • NPI 1578270633
  NPD (past)
• Kyonghyun Ko, PT

  • Physical Therapist
  • Flushing, NY
  • NPI 1831137926
  NPD (past)
• Dinesh Verma, D.O

  • Emergency Medicine Physician
  • Glen Cove, NY
  • NPI 1215035126
  NPD (past)
• German Laufer, M.D.

  • Neurology with Special Qualifications in Child Neurology Physician
  • West Orange, NJ
  • NPI 1952526816
  NPD (past)

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

{
    "created_epoch": "1156896000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1457461865",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1021 FORDHAM LN",
            "city": "WOODMERE",
            "state": "NY",
            "postal_code": "115981013",
            "telephone_number": "516-791-5750"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1021 FORDHAM LN",
            "city": "WOODMERE",
            "state": "NY",
            "postal_code": "115981013",
            "telephone_number": "516-791-5750"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "UNITED MEDICAL DIAGNOSTIC SERVICES P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-30",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "DATIKASHVILI",
        "authorized_official_first_name": "TEYMURAZ",
        "authorized_official_title_or_position": "MD",
        "authorized_official_telephone_number": "516-791-5750"
    },
    "taxonomies": [
        {
            "code": "208100000X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation",
            "state": "NY",
            "license": "211676",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE ID CODE",
            "identifier": "WEN 342",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Elka Rachel Travis
• Simone Trent
• Tymer Care Chiropractic, PC (TCC)
• Tzipporah Neuman Speech & Swallowing Therapy, PLLC
• Tzipporah Neuman Speech & Swallowing Therapy, PLLC
• Barbara Eve Untracht, M.A.
• Upstate Urgent Care PLLC
• Anne Vacker, SLP
• Daniel Vapne, DPT
• Gabriel Rene Vega

• Physical Medicine & Rehabilitation Physician in Woodmere, NY
• Providers in Woodmere, NY by specialty
• Physical Medicine & Rehabilitation Physician in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.