Organization Active NPI

Med-One Care, LLC

  • Urgent Care Clinic/Center
  • Dix Hills, NY
National Provider Identifier
1497925291
Registry record updated Mar 7, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Urgent Care Clinic/CenterTaxonomy code 261QU0200X
License
177073 Issued in NY
Legal business name
MED-ONE CARE, LLC
Practice address
4 Talon Way
Dix Hills, NY 11746-6239
Phone
(914) 217-6309
NPI assigned
Mar 7, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 7, 2008

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

Authorized official

Name
Dr. Samuel I Okonta, M DNPI 1295772648
Title
Ceo/ Medical Director
Phone
(914) 217-6309

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 2

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207P00000X 177073 NY
Urgent Care Clinic/Center 261QU0200X 177073 NY Primary

Addresses

Primary practice location

4 Talon Way
Dix Hills, NY 11746-6239

Mailing address

217-14 Merrick Boulevard
Lauelton, NY 11413
Phone (914) 217-6309

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20090728000277 NY Part B Supplier - Clinic/Group Practice 4082767850 Receives reassigned benefits from 2 practitioners
Practice locations: Laurelton, NY

National Provider Directory

National Provider Directory

Locations

21714 Merrick Blvd
Laurelton, NY 11413
Phone (718) 712-1428

Practitioners & affiliated clinicians

Practitioners 2

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

NPI Registry JSON

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

{
    "created_epoch": "1204848000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1204848000000",
    "number": "1497925291",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "217-14 MERRICK BOULEVARD",
            "city": "LAUELTON",
            "state": "NY",
            "postal_code": "11413",
            "telephone_number": "914-217-6309"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4 TALON WAY",
            "city": "DIX HILLS",
            "state": "NY",
            "postal_code": "117466239",
            "telephone_number": "914-217-6309"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MED-ONE CARE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-03-07",
        "last_updated": "2008-03-07",
        "status": "A",
        "authorized_official_last_name": "OKONTA",
        "authorized_official_first_name": "SAMUEL",
        "authorized_official_middle_name": "I",
        "authorized_official_title_or_position": "CEO/ MEDICAL DIRECTOR",
        "authorized_official_telephone_number": "914-217-6309",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M D"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Emergency Medicine",
            "state": "NY",
            "license": "177073",
            "primary": false
        },
        {
            "code": "261QU0200X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Urgent Care",
            "state": "NY",
            "license": "177073",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Dix Hills, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 7, 2008; 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.