Organization Active NPI

SK Medical Care PC

  • Geriatric Medicine (Internal Medicine) Physician
  • Woodbury, NY
National Provider Identifier
1578915351
Registry record updated Aug 29, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Geriatric Medicine (Internal Medicine) PhysicianTaxonomy code 207RG0300X
License
256574 Issued in NY
Legal business name
SK MEDICAL CARE PC
Practice address
2 Shannon Dr
Woodbury, NY 11797-1227
Phone
(631) 332-0686
NPI assigned
Jul 6, 2016
Last updated
Aug 29, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 29, 2024

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

Authorized official

Name
Syed A Kamal, M.D.NPI 1013232396
Title
President
Phone
(631) 332-0686

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
Geriatric Medicine (Internal Medicine) Physician 207RG0300X 256574 NY Primary

Addresses

Primary practice location

2 Shannon Dr
Woodbury, NY 11797-1227

Mailing address

2 Shannon Dr.
Woodbury, NY 11797-2110
Phone (631) 332-0686

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20160922000318 NY Part B Supplier - Clinic/Group Practice 6507153301 Receives reassigned benefits from 1 practitioner
Practice locations: Queens Village, NY; Rockville Centre, NY; Valley Stream, NY; Woodbury, NY

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1467763200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1724889600000",
    "number": "1578915351",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2 SHANNON DR.",
            "city": "WOODBURY",
            "state": "NY",
            "postal_code": "117972110",
            "telephone_number": "631-332-0686"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2 SHANNON DR",
            "city": "WOODBURY",
            "state": "NY",
            "postal_code": "117971227",
            "telephone_number": "631-332-0686"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SK MEDICAL CARE PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-07-06",
        "last_updated": "2024-08-29",
        "certification_date": "2024-08-29",
        "status": "A",
        "authorized_official_last_name": "KAMAL",
        "authorized_official_first_name": "SYED",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "631-332-0686",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207RG0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Geriatric Medicine",
            "state": "NY",
            "license": "256574",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Woodbury, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 29, 2024; 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.