Organization Active NPI

All Star Pediatrics PLLC

  • Pediatrics Physician
  • Peekskill, NY
National Provider Identifier
1609328202
Registry record updated Jan 3, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
258602 Issued in NY
Legal business name
ALL STAR PEDIATRICS PLLC
Practice address
2 Stowe Rd Ste 11
Peekskill, NY 10566-2582
Phone
(914) 737-4222
NPI assigned
Oct 30, 2016
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 3, 2020

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

Authorized official

Name
Azza Abdel-Hamid Abo-Deeb, MDNPI 1194808212
Title
Owner
Phone
(914) 737-4222

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
Pediatrics PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 208000000X 258602 NY Primary

Addresses

Primary practice location

2 Stowe Rd Ste 11
Peekskill, NY 10566-2582

Mailing address

2 Stowe Rd Ste 11
Peekskill, NY 10566-2582
Phone (914) 737-4222

Other identifiers 1

IdentifierTypeStateIssuer
02817105MedicaidNY

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
33D0911078All Star Pediatrics2 Stowe Road Suite 11, Peekskill, NY 10566Certificate of waiverJan 24, 2028

National Provider Directory

National Provider Directory

Locations

2 Stowe Rd
Ste 11
Peekskill, NY 10566
Phone (914) 734-7889

Practitioners & affiliated clinicians

Practitioners 1

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": "1477785600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1578009600000",
    "number": "1609328202",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2 STOWE RD STE 11",
            "city": "PEEKSKILL",
            "state": "NY",
            "postal_code": "105662582",
            "telephone_number": "914-737-4222"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2 STOWE RD STE 11",
            "city": "PEEKSKILL",
            "state": "NY",
            "postal_code": "105662582",
            "telephone_number": "914-737-4222"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ALL STAR PEDIATRICS PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-10-30",
        "last_updated": "2020-01-03",
        "certification_date": "2020-01-03",
        "status": "A",
        "authorized_official_last_name": "ABO-DEEB",
        "authorized_official_first_name": "AZZA",
        "authorized_official_middle_name": "ABDEL-HAMID",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "914-737-4222",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Pediatrics",
            "state": "NY",
            "license": "258602",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02817105",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Peekskill, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 3, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.