Individual provider Active NPI

Christopher Charles Paredes, M.D.

  • Geriatric Medicine (Family Medicine) Physician
  • New Hyde Park, NY
National Provider Identifier
1467707646
Registry record updated Jun 28, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Geriatric Medicine (Family Medicine) PhysicianTaxonomy code 207QG0300X
License
270465 Issued in NY
Practice address
1983 Marcus Ave
Suite C102
New Hyde Park, NY 11042-2000
Phone
(516) 876-4100
NPI assigned
Jul 13, 2012
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 28, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Geriatric Medicine (Family Medicine) Physician 207QG0300X 270465 NY Primary

Addresses

Primary practice location

1983 Marcus Ave
Suite C102
New Hyde Park, NY 11042-2000

Mailing address

1983 Marcus Ave
Suite C102
New Hyde Park, NY 11042-2000
Phone (516) 876-4100

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20130905000224 NY Practitioner - Family PracticePractitioner - Geriatric Medicine 8820231152 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family PracticeAlso: Geriatric Medicine
Education
Other, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
North Shore-Lij Medical Group PCGroup PAC ID 3971878901, 31 clinicians

Practice addresses (Care Compare)

1983 Marcus Ave
Suite C102
New Hyde Park, NY 11042-2006
Phone (516) 876-4100

Hospital & facility affiliations

  • North Shore Home Care Chha Home health agency, Westbury, NY, CCN 337148
  • Hospice Care of Long Island, Queens, South Shore Hospice, Woodbury, NY, CCN 331532

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
270465NYMDLicensed Practical Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
North Shore-Lij Medical PC CurrentSince Jun 13, 2016 Accepting new patients
Montefiore Medical Center CurrentSince Jul 1, 2013 Accepting new patients
North Shore - Lij Medical PC CurrentSince Jun 13, 2016 Accepting new patients
Montefiore Medical Center CurrentSince Jul 1, 2013 Accepting new patients
North Shore-Lij Medical Group P.C. CurrentSince Jul 30, 2017 Accepting new patients

Locations

111 E 210th St
Bronx, NY 10467

10201 66th Rd
Forest Hills, NY 11375
Phone (718) 830-4091

1983 Marcus Ave
Ste C102
New Hyde Park, NY 11042
Phone (516) 872-4100

1983 Marcus Ave
New Hyde Park, NY 11042
Phone (516) 326-5600

27005 76th Ave
North New Hyde Pk, NY 11040

27111 76th Ave
North New Hyde Pk, NY 11040
Phone (718) 289-2100

300 Community Dr
Plandome, NY 11030

972 Brush Hollow Rd
Westbury, NY 11590

Networks

  • Healthfirst Medicare Network H1722
  • Healthfirst Medicare Network H3359
  • Healthfirst Medicare Network H5989
  • Healthfirst Medicare Network H9678

Interoperability endpoints

  • Direct secure messaging: cparedes24506@northwell.direct-ci.com

Organizations & group practices 5

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 3

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1342137600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1467072000000",
    "number": "1467707646",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1983 MARCUS AVE",
            "address_2": "SUITE C102",
            "city": "NEW HYDE PARK",
            "state": "NY",
            "postal_code": "110422000",
            "telephone_number": "516-876-4100"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1983 MARCUS AVE",
            "address_2": "SUITE C102",
            "city": "NEW HYDE PARK",
            "state": "NY",
            "postal_code": "110422000",
            "telephone_number": "516-876-4100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PAREDES",
        "first_name": "CHRISTOPHER",
        "middle_name": "CHARLES",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2012-07-13",
        "last_updated": "2016-06-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207QG0300X",
            "taxonomy_group": "",
            "desc": "Family Medicine, Geriatric Medicine",
            "state": "NY",
            "license": "270465",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New Hyde Park, NY

Sources for this page

Verify at the official NPI Registry.