Organization Active NPI

Chowdhury Medical Care PC

  • Multi-Specialty Clinic/Center
  • Brooklyn, NY
National Provider Identifier
1467822882
Registry record updated Sep 28, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Multi-Specialty Clinic/CenterTaxonomy code 261QM1300X
Legal business name
CHOWDHURY MEDICAL CARE PC
Practice address
1084 Liberty Ave
Brooklyn, NY 11208-2923
Phone
(718) 277-2700
Fax
(718) 277-4191
NPI assigned
Sep 28, 2015
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 28, 2015

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

Authorized official

Name
Dr. Asm Shah Alam Chowdhury, M.DNPI 1356418511
Title
M.D
Phone
(718) 277-2700

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
Multi-Specialty Clinic/Center 261QM1300X Primary

Addresses

Primary practice location

1084 Liberty Ave
Brooklyn, NY 11208-2923

Mailing address

1084 Liberty Ave
Brooklyn, NY 11208-2923
Phone (718) 277-2700

Other identifiers 3

IdentifierTypeStateIssuer
211248OtherNYNY STATE LICENSE
607526764OtherNYTAX I'D
025993699MedicaidNY

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20160725000861 NY Part B Supplier - Clinic/Group Practice 6800189184 Receives reassigned benefits from 3 practitioners
Practice locations: Brooklyn, NY

National Provider Directory

National Provider Directory

Locations

1084 Liberty Ave
Brooklyn, NY 11208
Phone (347) 586-0625

Practitioners & affiliated clinicians

Practitioners 3

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": "1443398400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1443398400000",
    "number": "1467822882",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1084 LIBERTY AVE",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112082923",
            "telephone_number": "718-277-2700",
            "fax_number": "718-277-4191"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1084 LIBERTY AVE",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112082923",
            "telephone_number": "718-277-2700",
            "fax_number": "718-277-4191"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CHOWDHURY MEDICAL CARE PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-09-28",
        "last_updated": "2015-09-28",
        "status": "A",
        "authorized_official_last_name": "CHOWDHURY",
        "authorized_official_first_name": "ASM",
        "authorized_official_middle_name": "SHAH ALAM",
        "authorized_official_title_or_position": "M.D",
        "authorized_official_telephone_number": "718-277-2700",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D"
    },
    "taxonomies": [
        {
            "code": "261QM1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Multi-Specialty",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NY STATE LICENSE",
            "identifier": "211248",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TAX I'D",
            "identifier": "607526764",
            "state": "NY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "025993699",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Brooklyn, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 28, 2015; 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.