NPIMap

Organization Active NPI

Queens Psychiatric & Medical Care P.C.

  • Psychiatry Physician
  • Rego Park, NY
National Provider Identifier
1497119846
Registry record updated Apr 12, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
Legal business name
QUEENS PSYCHIATRIC & MEDICAL CARE P.C.
Practice address
9520 63Rd Rd
Suite J
Rego Park, NY 11374-1160
Phone
(718) 459-1225
Fax
(718) 459-5805
NPI assigned
Apr 12, 2016
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 12, 2016

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

Authorized official

Name
Raymond Tam, MD
Title
President
Phone
(718) 459-1225

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 2084P0800X Primary
Psychiatric/Mental Health Nurse PractitionerGroup: 193200000X MULTI-SPECIALTY GROUP 363LP0808X

Addresses

Primary practice location

9520 63Rd Rd
Suite J
Rego Park, NY 11374-1160

Mailing address

9520 63Rd Rd
Suite J
Rego Park, NY 11374-1160
Phone (718) 459-1225

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20160614001814 NY Part B Supplier - Clinic/Group Practice 0244521714 Receives reassigned benefits from 23 practitioners
Practice locations: Rego Park, NY

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 23

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

View all 23

NPI Registry JSON

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

{
    "created_epoch": "1460419200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1460419200000",
    "number": "1497119846",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9520 63RD RD",
            "address_2": "SUITE J",
            "city": "REGO PARK",
            "state": "NY",
            "postal_code": "113741160",
            "telephone_number": "718-459-1225",
            "fax_number": "718-459-5805"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9520 63RD RD",
            "address_2": "SUITE J",
            "city": "REGO PARK",
            "state": "NY",
            "postal_code": "113741160",
            "telephone_number": "718-459-1225",
            "fax_number": "718-459-5805"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "QUEENS PSYCHIATRIC & MEDICAL CARE P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-04-12",
        "last_updated": "2016-04-12",
        "status": "A",
        "authorized_official_last_name": "TAM",
        "authorized_official_first_name": "RAYMOND",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "718-459-1225",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Rego Park, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 12, 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.