Organization Active NPI

Medi City Pharmacy Inc.

  • Pharmacy
  • Jackson Heights, NY
National Provider Identifier
1558043844
Registry record updated Dec 9, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacyTaxonomy code 333600000X
Legal business name
MEDI CITY PHARMACY INC.
Practice address
7702 Roosevelt Ave Ste C
Jackson Heights, NY 11372-6604
Phone
(718) 255-1717
Fax
(718) 255-1851
NPI assigned
Aug 4, 2023
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 9, 2025

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

Authorized official

Name
Mr. Walter Orellana
Title
Owner
Phone
(718) 255-1717

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacy 333600000X Primary

Addresses

Primary practice location

7702 Roosevelt Ave Ste C
Jackson Heights, NY 11372-6604

Mailing address

7702 Roosevelt Ave Ste C
Jackson Heights, NY 11372-6604
Phone (718) 255-1717

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20231222001076 NY Part B Supplier - Mass Immunization (Roster Biller Only) 7113377730 Practice locations: Jackson Heights, NY
O20240301002988 NY DME Supplier - Pharmacy 7113377730 Practice locations: Jackson Heights, NY

Laboratory certificates & supplier records

Derived by NPIMap

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

Medicare medical equipment & supply locations

SupplierSuppliesMedicare assignment
Medi City Pharmacy Inc7702 Roosevelt Ave, Jackson Heights, NY 11372-6604(718) 255-1717 Epoetin|Immunosuppressive Drugs|Infusion Drugs|Nebulizer Drugs|Oral Anticancer Drugs|Oral Antiemetic Drugs Accepts assignmentParticipating since Nov 7, 2023

National Provider Directory

National Provider Directory

Locations

7702 Roosevelt Ave
Ste C
Jackson Heights, NY 11372
Phone (718) 255-1717

NPI Registry JSON

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

{
    "created_epoch": "1691107200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1765238400000",
    "number": "1558043844",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7702 ROOSEVELT AVE STE C",
            "city": "JACKSON HEIGHTS",
            "state": "NY",
            "postal_code": "113726604",
            "telephone_number": "718-255-1717",
            "fax_number": "718-255-1851"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7702 ROOSEVELT AVE STE C",
            "city": "JACKSON HEIGHTS",
            "state": "NY",
            "postal_code": "113726604",
            "telephone_number": "718-255-1717",
            "fax_number": "718-255-1851"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MEDI CITY PHARMACY INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-08-04",
        "last_updated": "2025-12-09",
        "certification_date": "2025-12-09",
        "status": "A",
        "authorized_official_last_name": "ORELLANA",
        "authorized_official_first_name": "WALTER",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "718-255-1717",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jackson Heights, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 9, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.