Eastside Medical Urgent Care, LLC

Primary specialty

Urgent Care Clinic/CenterTaxonomy code 261QU0200X

License

213296 Issued in NY

Legal business name

EASTSIDE MEDICAL URGENT CARE, LLC

Practice address

2226 Penfield Rd
Penfield, NY 14526-1922

Phone

(585) 388-5280

Fax

(585) 388-5282

NPI assigned

Dec 23, 2005

Organization subpart

No

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

Authorized official

Name

Tahmtan Hormozdyaran, M.D.

Title

Medical Director

Phone

(585) 388-5280

Specialties & licenses 1

Addresses

Practitioners 1

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

• Carol Diane Fague, RPA-C

  • Medical Physician Assistant
  • Rochester, NY
  • NPI 1851528798
  NPD

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

{
    "created_epoch": "1135296000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1534464000000",
    "number": "1528045135",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2226 PENFIELD RD",
            "city": "PENFIELD",
            "state": "NY",
            "postal_code": "145261922",
            "telephone_number": "585-388-5280",
            "fax_number": "585-388-5282"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2226 PENFIELD RD",
            "city": "PENFIELD",
            "state": "NY",
            "postal_code": "145261922",
            "telephone_number": "585-388-5280",
            "fax_number": "585-388-5282"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EASTSIDE MEDICAL URGENT CARE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-12-23",
        "last_updated": "2018-08-17",
        "status": "A",
        "authorized_official_last_name": "HORMOZDYARAN",
        "authorized_official_first_name": "TAHMTAN",
        "authorized_official_title_or_position": "MEDICAL DIRECTOR",
        "authorized_official_telephone_number": "585-388-5280",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "261QU0200X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Urgent Care",
            "state": "NY",
            "license": "213296",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jamie Drooz, LMHC
• Donald Duckles, MD
• Megan Catherine Durval
• Maria Jaroslavina Dyakiv, LPN
• Kathe Sue Dziura, R.N.
• Amanda Eggleton, LMSW
• Nicole Ehrne
• Elderwood Assisted Living at Penfield LLC
• Kirsten L Elting
• Episcopal Senior Housing, Penfield, LLC

• Urgent Care Clinic/Center in Penfield, NY
• Providers in Penfield, NY by specialty
• Urgent Care Clinic/Center in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 17, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.