NPIMap

Individual provider Active NPI

Roza Israel, M.D.

  • Internal Medicine Physician
  • Forest Hills, NY
National Provider Identifier
1528068368
Registry record updated Dec 19, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
214292 Issued in NY
Practice address
11241 Queens Blvd
Suite LLB
Forest Hills, NY 11375-7475
Phone
(718) 520-7723
Fax
(718) 520-7733
NPI assigned
Jul 22, 2005
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 19, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 214292 NY Primary

Addresses

Primary practice location

11241 Queens Blvd
Suite LLB
Forest Hills, NY 11375-7475

Mailing address

9925 65TH Rd
Rego Park, NY 11374-3654
Phone (718) 459-6505

Other identifiers 1

IdentifierTypeStateIssuer
01999980MedicaidNY

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050122000167 NY Practitioner - Internal Medicine 8426008921 Reassigns benefits to 1 organization
Practice locations: Jamaica, NY

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 1984
Medicare assignment
May accept Medicare assignment
Telehealth
Offers telehealth services
Group practices
I and R Medical Services, PCGroup PAC ID 9436109931, 2 clinicians

Practice addresses (Care Compare)

112 -41 Queens Blvd LLB
Forest Hills, NY 11375-5564
Phone (718) 520-7713

Hospital & facility affiliations

  • Emerest Home Health Care of Long Island Home health agency, Flushing, NY, CCN 337189
  • Americare Certified Special Services, Inc Chha Home health agency, Brooklyn, NY, CCN 337290
  • NYU Langone Hospitals Hospital, New York, NY, CCN 330214

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
214292NYMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
I & R Medical Services PC Internal Medicine CurrentSince Sep 19, 2004 Accepting new patients
The Silvercrest Center for Nursing and Rehabilitation Past Accepting new patients

Locations

6260 108th St
Ste 1J
Forest Hills, NY 11375

11241 Queens Blvd
Ste Llb
Forest Hills, NY 11375
Phone (718) 261-1759

Networks

  • Healthfirst Medicare Network H3359
  • Healthfirst Medicare Network H1722
  • Healthfirst Medicare Network H5989

Interoperability endpoints

  • Direct secure messaging: risrael@iandrmedicalservicespc.amazing-direct.com

Organizations & group practices 2

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

Hospital & facility affiliations 9

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": "1121990400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1387411200000",
    "number": "1528068368",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9925 65TH RD",
            "city": "REGO PARK",
            "state": "NY",
            "postal_code": "113743654",
            "telephone_number": "718-459-6505",
            "fax_number": "718-459-4247"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11241 QUEENS BLVD",
            "address_2": "SUITE LLB",
            "city": "FOREST HILLS",
            "state": "NY",
            "postal_code": "113757475",
            "telephone_number": "718-520-7723",
            "fax_number": "718-520-7733"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ISRAEL",
        "first_name": "ROZA",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2005-07-22",
        "last_updated": "2013-12-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NY",
            "license": "214292",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01999980",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Forest Hills, NY

Sources for this page

Verify at the official NPI Registry.