NPIMap

Organization Active NPI

Total Care Pediatric, PLLC

  • Pediatrics Physician
  • Flushing, NY
National Provider Identifier
1619508900
Registry record updated Jan 25, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
Legal business name
TOTAL CARE PEDIATRIC, PLLC
Practice address
4265 Kissena Blvd
Suite LL4
Flushing, NY 11355-3273
Phone
(718) 353-2300
NPI assigned
Jan 27, 2020
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 25, 2022

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

Authorized official

Name
Chak Wong
Title
Member
Phone
(718) 323-2300

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 208000000X Primary

Addresses

Primary practice location

4265 Kissena Blvd
Suite LL4
Flushing, NY 11355-3273

Mailing address

4265 Kissena Blvd
Suite LL4
Flushing, NY 11355-3273
Phone (718) 353-2300

National Provider Directory

National Provider Directory

Locations

4265 Kissena Blvd
Ste LL4
Flushing, NY 11355
Phone (718) 353-2300

4265 Kissena Blvd
#L4
Flushing, NY 11355
Phone (718) 353-2300

Practitioners & affiliated clinicians

Practitioners 5

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": "1580083200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1643068800000",
    "number": "1619508900",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4265 KISSENA BLVD",
            "address_2": "SUITE LL4",
            "city": "FLUSHING",
            "state": "NY",
            "postal_code": "113553273",
            "telephone_number": "718-353-2300",
            "fax_number": "718-353-2454"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4265 KISSENA BLVD",
            "address_2": "SUITE LL4",
            "city": "FLUSHING",
            "state": "NY",
            "postal_code": "113553273",
            "telephone_number": "718-353-2300"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TOTAL CARE PEDIATRIC, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-01-27",
        "last_updated": "2022-01-25",
        "certification_date": "2022-01-25",
        "status": "A",
        "authorized_official_last_name": "WONG",
        "authorized_official_first_name": "CHAK",
        "authorized_official_title_or_position": "MEMBER",
        "authorized_official_telephone_number": "718-323-2300"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Pediatrics",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Flushing, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 25, 2022; 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.