Organization Active NPI

Demetrios a Karides MD PC

  • Neurology Physician
  • Astoria, NY
National Provider Identifier
1497964951
Registry record updated Jan 28, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neurology PhysicianTaxonomy code 2084N0400X
License
210635 Issued in NY
Legal business name
DEMETRIOS A KARIDES MD PC
Practice address
2309 31St St Ste 5
Astoria, NY 11105-2452
Phone
(718) 204-7821
Fax
(718) 204-7826
NPI assigned
May 22, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 28, 2015

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

Authorized official

Name
Demetrios A Karides, M.D.NPI 1891797502
Title
Physician
Phone
(718) 204-7821

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
Neurology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 2084N0400X 210635 NY Primary

Addresses

Primary practice location

2309 31St St Ste 5
Astoria, NY 11105-2452

Mailing address

PO Box 5577
Astoria, NY 11105-5577
Phone (718) 204-7821

Other identifiers 2

IdentifierTypeStateIssuer
P00125338OtherNYMC RR
02258088MedicaidNY

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20090113000648 NY Part B Supplier - Clinic/Group Practice 3173697216 Receives reassigned benefits from 2 practitioners
Practice locations: Astoria, NY

National Provider Directory

National Provider Directory

Locations

2309 31st St
Ste 5
Astoria, NY 11105
Phone (718) 204-7821

Practitioners & affiliated clinicians

Practitioners 3

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": "1179792000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1422403200000",
    "number": "1497964951",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 5577",
            "city": "ASTORIA",
            "state": "NY",
            "postal_code": "111055577",
            "telephone_number": "718-204-7821",
            "fax_number": "718-204-7826"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2309 31ST ST STE 5",
            "city": "ASTORIA",
            "state": "NY",
            "postal_code": "111052452",
            "telephone_number": "718-204-7821",
            "fax_number": "718-204-7826"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DEMETRIOS A KARIDES MD PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-22",
        "last_updated": "2015-01-28",
        "status": "A",
        "authorized_official_last_name": "KARIDES",
        "authorized_official_first_name": "DEMETRIOS",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "PHYSICIAN",
        "authorized_official_telephone_number": "718-204-7821",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "2084N0400X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "NY",
            "license": "210635",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MC RR",
            "identifier": "P00125338",
            "state": "NY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02258088",
            "state": "NY"
        }
    ],
    "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 Jan 28, 2015; 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.