Organization Active NPI

Aurora Medical Care P.C.

  • Multi-Specialty Clinic/Center
  • Astoria, NY
National Provider Identifier
1487270443
Registry record updated Jun 26, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Multi-Specialty Clinic/CenterTaxonomy code 261QM1300X
Legal business name
AURORA MEDICAL CARE P.C.
Practice address
2936 30TH Ave
Astoria, NY 11102-2251
Phone
(347) 396-5612
NPI assigned
Jun 24, 2020
Last updated
Jun 26, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 26, 2020

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

Authorized official

Name
Usama Khayyal, MDNPI 1003105792
Title
President
Phone
(347) 396-5612

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 NU Primary

Addresses

Primary practice location

2936 30TH Ave
Astoria, NY 11102-2251

Mailing address

2936 30TH Ave
Astoria, NY 11102-2251
Phone (347) 396-5612

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20200729001540 NY Part B Supplier - Clinic/Group Practice 5294150959 Receives reassigned benefits from 4 practitioners
Practice locations: Astoria, NY

National Provider Directory

National Provider Directory

Locations

2936 30th Ave
Long Island City, NY 11102
Phone (347) 396-5612

Practitioners & affiliated clinicians

Practitioners 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1592956800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1593129600000",
    "number": "1487270443",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2936 30TH AVE",
            "city": "ASTORIA",
            "state": "NY",
            "postal_code": "111022251",
            "telephone_number": "347-396-5612"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2936 30TH AVE",
            "city": "ASTORIA",
            "state": "NY",
            "postal_code": "111022251",
            "telephone_number": "347-396-5612"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "AURORA MEDICAL CARE P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-06-24",
        "last_updated": "2020-06-26",
        "certification_date": "2020-06-26",
        "status": "A",
        "authorized_official_last_name": "KHAYYAL",
        "authorized_official_first_name": "USAMA",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "347-396-5612",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "261QM1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Multi-Specialty",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Astoria, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 26, 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.