Organization Active NPI

Mamta H Parikh MD PC

  • Internal Medicine Physician
  • Glen Head, NY
National Provider Identifier
1578350757
Registry record updated Apr 22, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
Legal business name
MAMTA H PARIKH MD PC
Practice address
2 Evans Dr
Glen Head, NY 11545-3145
Phone
(516) 216-9160
NPI assigned
Apr 22, 2025
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 22, 2025

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

Authorized official

Name
Mamta H Parikh, MDNPI 1639471279
Title
President
Phone
(516) 216-9160

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207R00000X Primary

Addresses

Primary practice location

2 Evans Dr
Glen Head, NY 11545-3145

Mailing address

425 N Broadway Unit 10
Jericho, NY 11753-5001
Phone (516) 216-9160

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20250512001237 NY Part B Supplier - Clinic/Group Practice 3577080670 Receives reassigned benefits from 1 practitioner
Practice locations: Glen Head, NY

National Provider Directory

National Provider Directory

Locations

425 N Broadway
Unit 10
Jericho, NY 11753

Practitioners & affiliated clinicians

Practitioners 2

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

NPI Registry JSON

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

{
    "created_epoch": "1745280000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1745280000000",
    "number": "1578350757",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "425 N BROADWAY UNIT 10",
            "city": "JERICHO",
            "state": "NY",
            "postal_code": "117535001",
            "telephone_number": "516-216-9160"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2 EVANS DR",
            "city": "GLEN HEAD",
            "state": "NY",
            "postal_code": "115453145",
            "telephone_number": "516-216-9160"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MAMTA H PARIKH MD PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-04-22",
        "last_updated": "2025-04-22",
        "certification_date": "2025-04-22",
        "status": "A",
        "authorized_official_last_name": "PARIKH",
        "authorized_official_first_name": "MAMTA",
        "authorized_official_middle_name": "H",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "516-216-9160",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Glen Head, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 22, 2025; 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.