Active NPI
Omicron Medical PC
- Internal Medicine Physician
- Forest Hills, NY
National Provider Identifier
1538696372
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Internal Medicine Physician
- License
- 2156381
- Legal business name
- OMICRON MEDICAL PC
- Practice address
- 10525 64TH Ave
Forest Hills, NY 11375-1640 - Phone
- (718) 459-3494
- Fax
- (718) 606-6069
- NPI assigned
- May 11, 2017
- Last updated
- May 11, 2017
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Dr. Ilya Burshteyn
- Title
- MD
- Phone
- (718) 459-3494
Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Internal Medicine Physician | 207R00000X | 2156381 | NY | Primary |
| Podiatrist | 213E00000X | N0060751 | NY |
Addresses
Primary practice location
10525 64TH Ave
Forest Hills, NY 11375-1640
Mailing address
10525 64TH Ave
Forest Hills, NY 11375-1640
Phone (718) 459-3494
National Provider Directory
National Provider DirectoryPractitioners & affiliated clinicians
Practitioners 1
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.
-
- General Practice Physician
- Forest Hills, NY
- NPI 1073546131
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1494460800000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1494460800000",
"number": "1538696372",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "10525 64TH AVE",
"city": "FOREST HILLS",
"state": "NY",
"postal_code": "113751640",
"telephone_number": "718-459-3494",
"fax_number": "718-606-6069"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "10525 64TH AVE",
"city": "FOREST HILLS",
"state": "NY",
"postal_code": "113751640",
"telephone_number": "718-459-3494",
"fax_number": "718-606-6069"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "OMICRON MEDICAL PC",
"organizational_subpart": "NO",
"enumeration_date": "2017-05-11",
"last_updated": "2017-05-11",
"status": "A",
"authorized_official_last_name": "BURSHTEYN",
"authorized_official_first_name": "ILYA",
"authorized_official_title_or_position": "MD",
"authorized_official_telephone_number": "718-459-3494",
"authorized_official_name_prefix": "Dr."
},
"taxonomies": [
{
"code": "207R00000X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Internal Medicine",
"state": "NY",
"license": "2156381",
"primary": true
},
{
"code": "213E00000X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Podiatrist",
"state": "NY",
"license": "N0060751",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Forest Hills, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 11, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.