Crest Medical Care, PC

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

267436-1 Issued in NY

Legal business name

CREST MEDICAL CARE, PC

Practice address

2520 146TH St
Flushing, NY 11354-1329

Phone

(347) 341-0365

Fax

(718) 886-0644

NPI assigned

Oct 14, 2016

Organization subpart

No

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

Authorized official

Name

Dr. Wu Tan, M.D.NPI 1518236181

Title

Owner

Phone

(347) 341-0365

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in NY

Enrollment records 1

Practitioners 3

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

• Wu Tan, MD

  • Internal Medicine Physician
  • Flushing, NY
  • NPI 1518236181
  Medicare reassignment NPD Authorized official
• Joshua Noah Halpern, MD

  • Radiation Oncology Physician
  • Brooklyn, NY
  • NPI 1649241100
  NPD (past)
• Jason Naziri, MD

  • Radiation Oncology Physician
  • Bronx, NY
  • NPI 1770074981
  NPD (past)

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

{
    "created_epoch": "1476403200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1476403200000",
    "number": "1538610522",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13336 41ST RD",
            "address_2": "SUITE 2G",
            "city": "FLUSHING",
            "state": "NY",
            "postal_code": "113553666",
            "telephone_number": "347-341-0365",
            "fax_number": "718-886-0644"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2520 146TH ST",
            "city": "FLUSHING",
            "state": "NY",
            "postal_code": "113541329",
            "telephone_number": "347-341-0365",
            "fax_number": "718-886-0644"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CREST MEDICAL CARE, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-10-14",
        "last_updated": "2016-10-14",
        "status": "A",
        "authorized_official_last_name": "TAN",
        "authorized_official_first_name": "WU",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "347-341-0365",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine",
            "state": "NY",
            "license": "267436-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Robert S Crupi, MD
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• Carlos Cruz-Perez, MD

• Internal Medicine Physician in Flushing, NY
• Providers in Flushing, NY by specialty
• Internal Medicine Physician in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 14, 2016; 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.