Eneida Agosto-Colon, MD
Individual provider Active NPI Rheumatology Physician · Jackson Heights, NY
NPI 1629165162 · NPPES record last updated Jun 19, 2014
Key facts
- NPI
- 1629165162
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Rheumatology Physician 207RR0500X
- License
- 211512 (NY)
- Practice address
- 3713 85TH St BSMT
Jackson Heights, NY 11372-7352 - Phone
- (718) 507-5400
- Fax
- (718) 507-5422
- NPI assigned
- Oct 6, 2006
- Sex
- Female
- Sole proprietor
- Yes
Organizations & group practices 3
Medicare Care Compare profile
- Specialty
- Rheumatology
- Education
- Other, 1991
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
Practice addresses (Care Compare)
3713 85TH St
Jackson Heights, NY 11372-7352
Phone (718) 507-5400
3713 85TH St BSMT
Jackson Heights, NY 11372-7352
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in NY
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20070817000161 | NY | Practitioner - Rheumatology |
7719079912 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
Practice roles (2 of 6)
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Marc Waldman,DPM PC | Past | Accepting new patients | |
| Queens County Podiatry PC | Past |
Accepting new patients |
Networks
- Healthfirst Medicare Network H1722
- Healthfirst Medicare Network H9678
- Healthfirst Medicare Network H3359
- Healthfirst Medicare Network H5989
Interoperability endpoints
- https://fhir4.healow.com/fhir/r4/BIEIAA/Endpoint/BIEIAA
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Rheumatology Physician | 207RR0500X | 211512 | NY | Yes |
Addresses
Primary practice location
3713 85TH St BSMT
Jackson Heights, NY 11372-7352
Mailing address
3713 85TH St BSMT
Jackson Heights, NY 11372-7352
Phone (718) 507-5400
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 02129564 | Medicaid | NY |
Other providers in Jackson Heights, NY
- Advanced Urology Associates, LLC
- Aen Corp
- Aesthetics & OBGYN for Advanced Women Care, P.C.
- Shirley Afonso Marshall
- Adele I Agin
- Aktar Ahmed
- Faruque Ahmed
- Hosne Fahmida Ahmed
- Mustaque Ahmed
- Rounak Ahmed
All providers in Jackson Heights, NY · Rheumatology Physician in New York
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jun 19, 2014. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.