4016 Elmhurst Medical PC

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

Legal business name

4016 ELMHURST MEDICAL PC

Practice address

4016 74TH St
Elmhurst, NY 11373-5602

Phone

(718) 682-7090

NPI assigned

Jul 8, 2021

Organization subpart

No

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

Authorized official

Name

Choudhury HasanNPI 1669850210

Title

MD

Phone

(917) 336-8422

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in NY

Enrollment records 1

Locations

Practitioners 5

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

• Choudhury Mohammed Sajedul Hasan, M.D.

  • Hospitalist Physician
  • Flushing, NY
  • NPI 1669850210

  Internal Medicine

  Medicare reassignment NPD Authorized official
• Saniya Ahmed

  • Internal Medicine Physician
  • Manhasset, NY
  • NPI 1669759684
  Medicare reassignment NPD
• Shalena Islam, MD

  • Family Medicine Physician
  • Flushing, NY
  • NPI 1386120095

  Single Specialty

  Medicare reassignment NPD
• Leelamma Samuel, M.D

  • Pediatrics Physician
  • Flushing, NY
  • NPI 1205122512
  Medicare reassignment NPD
• Tahera Aktar, PA

  • Physician Assistant
  • Forest Hills, NY
  • NPI 1730898818
  Medicare reassignment

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

{
    "created_epoch": "1625702400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1670544000000",
    "number": "1497326607",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4016 74TH ST",
            "city": "ELMHURST",
            "state": "NY",
            "postal_code": "113735602"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4016 74TH ST",
            "city": "ELMHURST",
            "state": "NY",
            "postal_code": "113735602",
            "telephone_number": "718-682-7090"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "4016 ELMHURST MEDICAL PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-07-08",
        "last_updated": "2022-12-09",
        "certification_date": "2022-12-09",
        "status": "A",
        "authorized_official_last_name": "HASAN",
        "authorized_official_first_name": "CHOUDHURY",
        "authorized_official_title_or_position": "MD",
        "authorized_official_telephone_number": "917-336-8422"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• 1219 First Avenue Pharmacy Inc
• 8737 Britton Ave Pharmacy Inc
• 9330 LLC
• 99 Pharmacy, Inc.
• A and R Medical Supply Corp
• A Better Tomorrow Mental Health Counseling, PLLC

• Internal Medicine Physician in Elmhurst, NY
• Providers in Elmhurst, NY by specialty
• Internal Medicine Physician in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 9, 2022; 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.