NPIMap

Organization Active NPI

Cordial Medical, P.C.

  • Infectious Disease Physician
  • Farmingdale, NY
National Provider Identifier
1528512894
Registry record updated Feb 21, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Infectious Disease PhysicianTaxonomy code 207RI0200X
Legal business name
CORDIAL MEDICAL, P.C.
Practice address
100 Broadhollow Rd Ste 106
Farmingdale, NY 11735-4813
Phone
(631) 693-6644
Fax
(631) 693-4389
NPI assigned
Aug 4, 2016
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 21, 2018

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

Authorized official

Name
Mohammud Alam, MDNPI 1881601052
Title
MD, Owner
Phone
(631) 693-6644

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
Infectious Disease PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207RI0200X Primary

Addresses

Primary practice location

100 Broadhollow Rd Ste 106
Farmingdale, NY 11735-4813

Mailing address

22001 Jamaica Ave
2ND FL
Queens Village, NY 11428-2140
Phone (718) 878-4177

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20180402000857 NY Part B Supplier - Clinic/Group Practice 6800158817 Receives reassigned benefits from 3 practitioners
Practice locations: Farmingdale, NY

National Provider Directory

National Provider Directory

Locations

100 Broadhollow Rd
Ste 106
Farmingdale, NY 11735
Phone (631) 693-6644

Practitioners & affiliated clinicians

Practitioners 7

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": "1470268800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1519171200000",
    "number": "1528512894",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "22001 JAMAICA AVE",
            "address_2": "2ND FL",
            "city": "QUEENS VILLAGE",
            "state": "NY",
            "postal_code": "114282140",
            "telephone_number": "718-878-4177"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 BROADHOLLOW RD STE 106",
            "city": "FARMINGDALE",
            "state": "NY",
            "postal_code": "117354813",
            "telephone_number": "631-693-6644",
            "fax_number": "631-693-4389"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CORDIAL MEDICAL, P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-08-04",
        "last_updated": "2018-02-21",
        "status": "A",
        "authorized_official_last_name": "ALAM",
        "authorized_official_first_name": "MOHAMMUD",
        "authorized_official_title_or_position": "MD, OWNER",
        "authorized_official_telephone_number": "631-693-6644",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207RI0200X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine, Infectious Disease",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Farmingdale, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 21, 2018; 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.