Individual provider Active NPI

Patricia Edmondson

  • Pediatric Pulmonology Physician
  • Flushing, NY
National Provider Identifier
1588770481
Registry record updated Jan 17, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Pulmonology PhysicianTaxonomy code 2080P0214X
License
178526 Issued in NY
Practice address
4500 Parsons Blvd.
Acc
Flushing, NY 11355
Phone
(718) 670-5486
NPI assigned
Aug 22, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 17, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Pulmonology Physician 2080P0214X 178526 NY Primary

Addresses

Primary practice location

4500 Parsons Blvd.
Acc
Flushing, NY 11355

Mailing address

80 Marcus Drive
Provider Enrollment
Melville, NY 11747
Phone (631) 391-7889

Other identifiers 1

IdentifierTypeStateIssuer
01446368MedicaidNY

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050613000847 NY Practitioner - Pulmonary Disease 2062456833 Reassigns benefits to 3 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Flushing Hospital Medical Center CurrentSince Nov 28, 2011 Accepting new patients
TJH Medical Services, P.C. CurrentSince Nov 28, 2011 Accepting new patients
Jamaica Hospital CurrentSince Oct 20, 2011 Accepting new patients
Jamaica Hospital CurrentSince Oct 20, 2011 Accepting new patients
Flushing Hospital & Medical Center CurrentSince Nov 28, 2011 Accepting new patients
Jamaica Hospital Medical Center Past Accepting new patients

Locations

4500 Parsons Blvd
Flushing, NY 11355
Phone (718) 670-5631

14601 45th Ave
Flushing, NY 11355
Phone (718) 670-5562

18803 Jamaica Ave
Jamaica, NY 11423
Phone (718) 740-2060

11940 Metropolitan Ave
Kew Gardens, NY 11415
Phone (718) 849-0839

80 Marcus Dr
Melville, NY 11747
Phone (631) 391-7889

13303 Jamaica Ave
Richmond Hill, NY 11418
Phone (718) 206-6942

Networks

  • Healthfirst Medicare Network H9678
  • Healthfirst Medicare Network H5989
  • Healthfirst Medicare Network H1722
  • Healthfirst Medicare Network H3359

Interoperability endpoints

  • Direct secure messaging: pedmondson6784@direct.medisys.org

Organizations & group practices 6

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1156204800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1358380800000",
    "number": "1588770481",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "80 MARCUS DRIVE",
            "address_2": "PROVIDER ENROLLMENT",
            "city": "MELVILLE",
            "state": "NY",
            "postal_code": "11747",
            "telephone_number": "631-391-7889",
            "fax_number": "631-454-4163"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4500 PARSONS BLVD.",
            "address_2": "ACC",
            "city": "FLUSHING",
            "state": "NY",
            "postal_code": "11355",
            "telephone_number": "718-670-5486"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EDMONDSON",
        "first_name": "PATRICIA",
        "name_prefix": "Dr.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-22",
        "last_updated": "2013-01-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2080P0214X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Pulmonology",
            "state": "NY",
            "license": "178526",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01446368",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Flushing, NY

Sources for this page

Verify at the official NPI Registry.