Individual provider Active NPI

Jerry Noel Centeno, M.D.

  • Cardiovascular Disease Physician
  • Flushing, NY
National Provider Identifier
1508220856
Registry record updated Mar 26, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Cardiovascular Disease PhysicianTaxonomy code 207RC0000X
License
192868 Issued in CA
Practice address
5645 Main St
Flushing, NY 11355-5045
Phone
(718) 670-2000
NPI assigned
Apr 12, 2016
Last updated
Mar 26, 2025By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 26, 2025

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Cardiovascular Disease Physician 207RC0000X MD224604 OR
Cardiovascular Disease Physician 207RC0000X 192868 CA Primary
Internal Medicine Physician 207R00000X 299633 NY

Addresses

Primary practice location

5645 Main St
Flushing, NY 11355-5045

Mailing address

5645 Main St
Flushing, NY 11355-5045
Phone (718) 670-2000

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY, CA, OR3 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 3

Enrollment IDStateProvider typePAC IDDetails
I20191230000809 NY Practitioner - Cardiovascular Disease (Cardiology)Practitioner - Internal Medicine 1951649383 Reassigns benefits to 2 organizations
I20240925003653 CA Practitioner - Cardiovascular Disease (Cardiology) 1951649383 Reassigns benefits to 1 organization
I20250421002147 OR Practitioner - Cardiovascular Disease (Cardiology) 1951649383 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Cardiovascular Disease (Cardiology)
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Arnot Ogden Medical CenterGroup PAC ID 5395798417, 219 clinicians
Harinder S. Gogia, M.D., Inc.Group PAC ID 8527045004, 5 clinicians

Practice addresses (Care Compare)

1111 Crater Lake Ave
Medford, OR 97504-6241
Phone (541) 732-5250

1698 E McAndrews Rd
Suite 300
Medford, OR 97504-5590
Phone (541) 732-7850

600 Roe Ave
Elmira, NY 14905-1629
Phone 60773741004118

801 N Tustin Ave
Suite 706
Santa Ana, CA 92705-3611
Phone (714) 568-6600

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
80.15 of 100Reported as group
Quality
46.76
Promoting interoperability
100
Improvement activities
40
Cost
77.08

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
192868CAMDCardiovascular Disease Physician
MD224604ORMDCardiovascular Disease Physician

Practice roles

OrganizationSpecialtyStatusNew patients
New York Queens Medicine and Surgery, P.C. CurrentSince Nov 2, 2019 Accepting new patients
Providence Health & Services - Oregon Current Accepting new patients
Providence Health & Services - Oregon Internal Medicine CurrentSince Apr 1, 2025 Accepting new patients
Harinder S. Gogia, M.D., Inc. CurrentSince Aug 5, 2024 Accepting new patients
Providence Health & Services Oregon Internal Medicine Current Accepting new patients
Providence Health & Services - Oregon Internal Medicine CurrentSince Apr 1, 2025 Accepting new patients
New York Queens Medicine and Surgery, P.C. CurrentSince Nov 2, 2019 Accepting new patients
Providence Health & Services - Oregon CurrentSince Apr 1, 2025 Accepting new patients

Locations

1801 W Romneya Dr
Ste 403
Anaheim, CA 92801
Phone (714) 491-7000

1325 N Rose Dr
Ste 208
Placentia, CA 92870
Phone (714) 203-1283

801 N Tustin Ave
Ste 706
Santa Ana, CA 92705
Phone (714) 568-6600

5645 Main St
Flushing, NY 11355
Phone (718) 670-1435

16303 Horace Harding Expy
Fl 2
Fresh Meadows, NY 11365
Phone (718) 888-9121

1981 Marcus Ave
Ste 208
North New Hyde Park, NY 11042
Phone (718) 670-1415

1111 Crater Lake Ave
Medford, OR 97504
Phone (541) 732-5250

1698 E McAndrews Rd
Ste 300
Medford, OR 97504
Phone (541) 732-7850

940 Royal Ave
Unit 350
Medford, OR 97504
Phone (541) 732-7460

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

Organizations & group practices 9

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 6

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1460419200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1742947200000",
    "number": "1508220856",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5645 MAIN ST",
            "city": "FLUSHING",
            "state": "NY",
            "postal_code": "113555045",
            "telephone_number": "718-670-2000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5645 MAIN ST",
            "city": "FLUSHING",
            "state": "NY",
            "postal_code": "113555045",
            "telephone_number": "718-670-2000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CENTENO",
        "first_name": "JERRY",
        "middle_name": "NOEL",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-04-12",
        "last_updated": "2025-03-26",
        "certification_date": "2025-03-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "OR",
            "license": "MD224604",
            "primary": false
        },
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "CA",
            "license": "192868",
            "primary": true
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NY",
            "license": "299633",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Flushing, NY

Sources for this page

Verify at the official NPI Registry.