Individual provider Active NPI

Johanny Lama

  • Specialist
  • Astoria, NY
National Provider Identifier
1609535806
Registry record updated Dec 15, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
2665832 Issued in NY
Practice address
2759 Crescent St BSMT
Astoria, NY 11102-4292
Phone
(718) 626-0111
NPI assigned
Dec 15, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 15, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 2665832 NY
Specialist 174400000X 2665832 NY Primary

Addresses

Primary practice location

2759 Crescent St BSMT
Astoria, NY 11102-4292

Mailing address

2759 Crescent St BSMT
Astoria, NY 11102-4292
Phone (718) 626-0111

Electronic endpoints 1

TypeEndpointUseAffiliation
Other URL Work

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
2665832NYMDPediatrics Physician

NPI Registry JSON

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

{
    "created_epoch": "1639526400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1639526400000",
    "number": "1609535806",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2759 CRESCENT ST BSMT",
            "city": "ASTORIA",
            "state": "NY",
            "postal_code": "111024292",
            "telephone_number": "718-626-0111"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2759 CRESCENT ST BSMT",
            "city": "ASTORIA",
            "state": "NY",
            "postal_code": "111024292",
            "telephone_number": "718-626-0111"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LAMA",
        "first_name": "JOHANNY",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-12-15",
        "last_updated": "2021-12-15",
        "certification_date": "2021-12-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "NY",
            "license": "2665832",
            "primary": false
        },
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "NY",
            "license": "2665832",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "Work",
            "affiliation": "N",
            "address_1": "2759 Crescent St Bsmt",
            "city": "Astoria",
            "state": "NY",
            "country_code": "US",
            "postal_code": "111024292",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Astoria, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 15, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.