Organization Active NPI

Pancare Medical PC

  • Family Medicine Physician
  • Jamaica, NY
National Provider Identifier
1457548745
Registry record updated Feb 10, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
243375 Issued in NY
Legal business name
PANCARE MEDICAL PC
Practice address
15915 Hillside Ave
Jamaica, NY 11432-3935
Phone
(718) 473-2005
Fax
(718) 523-2311
NPI assigned
Oct 1, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 10, 2014

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

Authorized official

Name
Dr. Silas E Nwaishienyi, M.DNPI 1336269802
Title
Director
Phone
(516) 610-8704

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: 193200000X MULTI-SPECIALTY GROUP 207Q00000X 243375 NY Primary

Addresses

Primary practice location

15915 Hillside Ave
Jamaica, NY 11432-3935

Mailing address

15915 Hillside Ave
Jamaica, NY 11432-3935
Phone (718) 473-2005

Other identifiers 1

IdentifierTypeStateIssuer
243375OtherNYLICENSE

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20080304000826 NY Part B Supplier - Clinic/Group Practice 5193800951 Receives reassigned benefits from 1 practitioner
Practice locations: Jamaica, NY

National Provider Directory

National Provider Directory

Locations

15912 Hillside Ave
Jamaica, NY 11432
Phone (718) 523-2310

Practitioners & affiliated clinicians

Practitioners 1

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": "1191196800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1391990400000",
    "number": "1457548745",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15915 HILLSIDE AVE",
            "city": "JAMAICA",
            "state": "NY",
            "postal_code": "114323935",
            "telephone_number": "718-473-2005",
            "fax_number": "718-523-2311"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15915 HILLSIDE AVE",
            "city": "JAMAICA",
            "state": "NY",
            "postal_code": "114323935",
            "telephone_number": "718-473-2005",
            "fax_number": "718-523-2311"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PANCARE MEDICAL PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-10-01",
        "last_updated": "2014-02-10",
        "status": "A",
        "authorized_official_last_name": "NWAISHIENYI",
        "authorized_official_first_name": "SILAS",
        "authorized_official_middle_name": "E",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "516-610-8704",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": "NY",
            "license": "243375",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE",
            "identifier": "243375",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Jamaica, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 10, 2014; 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.