Kings Park Medicine PC

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

258181-1 Issued in NY

Legal business name

KINGS PARK MEDICINE PC

Practice address

93 Main St
Suite a
Kings Park, NY 11754-2740

Phone

(631) 292-2725

Fax

(631) 292-2727

NPI assigned

Aug 26, 2013

Organization subpart

No

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

Authorized official

Name

Weymin G Hago, MDNPI 1992941314

Title

Medical Director

Phone

(631) 292-2725

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in NY

Enrollment records 1

Locations

Practitioners 1

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

• Weymin Hago, MD

  • Internal Medicine Physician
  • New York, NY
  • NPI 1992941314
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1377475200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1377475200000",
    "number": "1609200716",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "93 MAIN ST",
            "address_2": "SUITE A",
            "city": "KINGS PARK",
            "state": "NY",
            "postal_code": "117542740",
            "telephone_number": "631-292-2725",
            "fax_number": "631-292-2727"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "93 MAIN ST",
            "address_2": "SUITE A",
            "city": "KINGS PARK",
            "state": "NY",
            "postal_code": "117542740",
            "telephone_number": "631-292-2725",
            "fax_number": "631-292-2727"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KINGS PARK MEDICINE PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-08-26",
        "last_updated": "2013-08-26",
        "status": "A",
        "authorized_official_last_name": "HAGO",
        "authorized_official_first_name": "WEYMIN",
        "authorized_official_middle_name": "G",
        "authorized_official_title_or_position": "MEDICAL DIRECTOR",
        "authorized_official_telephone_number": "631-292-2725",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": "NY",
            "license": "258181-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Heather F Kennedy
• Rachael Kern
• KFP Corp
• Kings Park Central School District
• Kings Park Fire Dist
• Kings Park Physical Therapy PC
• Kings Park Podiatry PLLC
• Kings Park Primary Medical Care PC
• Sabrina Angela Klemballa
• Tonianne Klis

• Family Medicine Physician in Kings Park, NY
• Providers in Kings Park, NY by specialty
• Family Medicine Physician in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 26, 2013; 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.