Nyc Primary Medical Care PC

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

232944 Issued in NY

Legal business name

NYC PRIMARY MEDICAL CARE PC

Practice address

310 E 14TH St
New York, NY 10003-4201

Phone

(212) 979-4204

Fax

(212) 979-4415

NPI assigned

Mar 29, 2017

Last updated

Mar 29, 2017By 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

Mahyar Eidgah, MDNPI 1710023601

Title

Owner

Phone

(212) 979-4204

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in NY

Enrollment records 1

Locations

Practitioners 2

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.

• Mahyar Eidgah, M.D.

  • Family Medicine Physician
  • New York, NY
  • NPI 1710023601
  Medicare reassignment NPD Authorized official
• Inessa Krel, NP

  • Family Nurse Practitioner
  • New York, NY
  • NPI 1104286061
  NPD (past)

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

{
    "created_epoch": "1490745600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1490745600000",
    "number": "1467984500",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "310 E 14TH ST",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100034201",
            "telephone_number": "212-979-4204",
            "fax_number": "212-979-4415"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "310 E 14TH ST",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100034201",
            "telephone_number": "212-979-4204",
            "fax_number": "212-979-4415"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NYC PRIMARY MEDICAL CARE PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-03-29",
        "last_updated": "2017-03-29",
        "status": "A",
        "authorized_official_last_name": "EIDGAH",
        "authorized_official_first_name": "MAHYAR",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "212-979-4204",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": "NY",
            "license": "232944",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Family Medicine Physician in New York, NY
• Providers in New York, NY by specialty
• Family Medicine Physician in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 29, 2017; 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.