Active NPI
Dominic Gerard Amendolara, RPH
- Pharmacist
- Flushing, NY
National Provider Identifier
1558404145
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 038649
- Practice address
- 14919 Union Tpke
Flushing, NY 11367-3849 - Phone
- (718) 380-5440
- Fax
- (718) 380-3028
- NPI assigned
- Feb 14, 2007
- Last updated
- Jul 8, 2007
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | 038649 | NY | Primary |
Addresses
Primary practice location
14919 Union Tpke
Flushing, NY 11367-3849
Mailing address
14919 Union Tpke
Flushing, NY 11367-3849
Phone (718) 380-5440
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 038649 | Other | NY | NYS RPH LIC NUMBER |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Registered Pharmacist
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 038649 | NY | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Jppa Pharmacy Inc | Past | Accepting new patients |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1171411200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1558404145",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "14919 UNION TPKE",
"city": "FLUSHING",
"state": "NY",
"postal_code": "113673849",
"telephone_number": "718-380-5440",
"fax_number": "718-380-3028"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "14919 UNION TPKE",
"city": "FLUSHING",
"state": "NY",
"postal_code": "113673849",
"telephone_number": "718-380-5440",
"fax_number": "718-380-3028"
}
],
"practiceLocations": [],
"basic": {
"last_name": "AMENDOLARA",
"first_name": "DOMINIC",
"middle_name": "GERARD",
"name_prefix": "Mr.",
"credential": "RPH",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2007-02-14",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "NY",
"license": "038649",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "NYS RPH LIC NUMBER",
"identifier": "038649",
"state": "NY"
}
],
"endpoints": [],
"other_names": []
}Other providers in Flushing, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.