NPIMap

Organization Active NPI

Harlem Medical Associates PC

  • General Practice Physician
  • New York, NY
National Provider Identifier
1487957692
Registry record updated Sep 2, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice PhysicianTaxonomy code 208D00000X
Legal business name
HARLEM MEDICAL ASSOCIATES PC
Practice address
506 Malcolm X Blvd (Lenox Ave)
New York, NY 10037-1802
Phone
(631) 675-9300
Fax
(631) 675-9301
NPI assigned
Dec 9, 2010
Last updated
Sep 2, 2016By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 2, 2016

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

Authorized official

Name
Sudha Pentyala
Title
Director
Phone
(631) 675-9300

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 208D00000X Primary

Addresses

Primary practice location

506 Malcolm X Blvd (Lenox Ave)
New York, NY 10037-1802

Mailing address

45 Research Way
Suite 206
East Setauket, NY 11733-6401
Phone (631) 675-9300

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20110315000005 NY Part B Supplier - Clinic/Group Practice 9335321223 Receives reassigned benefits from 782 practitioners
Practice locations: New York, NY

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 841

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.

View all 841

NPI Registry JSON

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

{
    "created_epoch": "1291852800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1472774400000",
    "number": "1487957692",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "45 RESEARCH WAY",
            "address_2": "SUITE 206",
            "city": "EAST SETAUKET",
            "state": "NY",
            "postal_code": "117336401",
            "telephone_number": "631-675-9300",
            "fax_number": "631-675-9301"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "506 MALCOLM X BLVD (LENOX AVE)",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100371802",
            "telephone_number": "631-675-9300",
            "fax_number": "631-675-9301"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HARLEM MEDICAL ASSOCIATES PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-12-09",
        "last_updated": "2016-09-02",
        "status": "A",
        "authorized_official_last_name": "PENTYALA",
        "authorized_official_first_name": "SUDHA",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "631-675-9300"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "General Practice",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 2, 2016; 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.