Ideal Medical Care of New York, PLLC

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

219511 Issued in NY

Legal business name

IDEAL MEDICAL CARE OF NEW YORK, PLLC

Practice address

2 Arkansas Dr
Valley Stream, NY 11580-1801

Phone

(516) 285-1270

Fax

(516) 285-1271

NPI assigned

Oct 30, 2009

Organization subpart

No

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

Authorized official

Name

Zeeshan Sultana Hasan, M.D.NPI 1528005907

Title

President

Phone

(516) 285-1270

Specialties & licenses 1

Addresses

Other identifiers 2

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.

• Zeeshan Sultana Hasan, MD

  • Internal Medicine Physician
  • Valley Stream, NY
  • NPI 1528005907
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1256860800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1539475200000",
    "number": "1629304357",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 304",
            "city": "VALLEY STREAM",
            "state": "NY",
            "postal_code": "115820304",
            "telephone_number": "516-285-1270",
            "fax_number": "516-285-1271"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2 ARKANSAS DR",
            "city": "VALLEY STREAM",
            "state": "NY",
            "postal_code": "115801801",
            "telephone_number": "516-285-1270",
            "fax_number": "516-285-1271"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "IDEAL MEDICAL CARE OF NEW YORK, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-10-30",
        "last_updated": "2018-10-14",
        "status": "A",
        "authorized_official_last_name": "HASAN",
        "authorized_official_first_name": "ZEESHAN",
        "authorized_official_middle_name": "SULTANA",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "516-285-1270",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine",
            "state": "NY",
            "license": "219511",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02149580",
            "state": "NY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3830522",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Internal Medicine Physician in Valley Stream, NY
• Providers in Valley Stream, NY by specialty
• Internal Medicine Physician in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 14, 2018; 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.