Michael Tsadyk Medical PC

Key facts

NPI

1548089246

Entity type

Organization (NPI type 2)

Primary specialty

Family Medicine Physician 207Q00000X

Legal business name

MICHAEL TSADYK MEDICAL PC

Practice address

10721 Queens Blvd Ste 6
Forest Hills, NY 11375-4451

Phone

(929) 450-7007

Fax

(929) 506-7006

NPI assigned

Oct 9, 2024

Organization subpart

No

Authorized official

Name

Michael Tsadyk, MD NPI 1194212902

Title

Physician

Phone

(929) 450-7007

Authorized official NPPES reports the authorized official by name only; the link goes to the one practitioner connected to this organization with that name.

Practitioners 1

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

• Michael Tsadyk, MD Family Medicine Physician · Forest Hills, NY · NPI 1194212902
  Medicare reassignment NPD Authorized official FAMILY MEDICINE · NY

Laboratory certificates & supplier records

Name & address match These CMS records do not include an NPI. They are shown here because their name and street address match this provider’s.

CLIA laboratory certificates

Medicare participation

Medicare fee-for-service enrollment

Enrolled in NY

Medicare enrollment records

National Provider Directory

Specialties & licenses

Addresses

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on Oct 9, 2024.

{
    "created_epoch": "1728432000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1728432000000",
    "number": "1548089246",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10721 QUEENS BLVD STE 6",
            "city": "FOREST HILLS",
            "state": "NY",
            "postal_code": "113754451",
            "telephone_number": "929-450-7007",
            "fax_number": "929-506-7006"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10721 QUEENS BLVD STE 6",
            "city": "FOREST HILLS",
            "state": "NY",
            "postal_code": "113754451",
            "telephone_number": "929-450-7007",
            "fax_number": "929-506-7006"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MICHAEL TSADYK MEDICAL PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-10-09",
        "last_updated": "2024-10-09",
        "certification_date": "2024-10-09",
        "status": "A",
        "authorized_official_last_name": "TSADYK",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_title_or_position": "PHYSICIAN",
        "authorized_official_telephone_number": "929-450-7007",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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