Hollis Medical Care, P.C.

Primary specialty

Surgery PhysicianTaxonomy code 208600000X

Legal business name

HOLLIS MEDICAL CARE, P.C.

Practice address

19002 Jamaica Ave
Hollis, NY 11423-2516

Phone

(718) 740-0710

Fax

(718) 740-0755

NPI assigned

Jun 20, 2007

Last updated

Sep 11, 2025By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mr. Simon Davydov

Title

Administrator

Phone

(718) 740-0710

Specialties & licenses 2

Addresses

Other identifiers 3

Locations

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

{
    "created_epoch": "1182297600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1757548800000",
    "number": "1639374390",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "19002 JAMAICA AVE",
            "city": "HOLLIS",
            "state": "NY",
            "postal_code": "114232516",
            "telephone_number": "718-740-0710",
            "fax_number": "718-740-0755"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "19002 JAMAICA AVE",
            "city": "HOLLIS",
            "state": "NY",
            "postal_code": "114232516",
            "telephone_number": "718-740-0710",
            "fax_number": "718-740-0755"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HOLLIS MEDICAL CARE, P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-06-20",
        "last_updated": "2025-09-11",
        "status": "A",
        "authorized_official_last_name": "DAVYDOV",
        "authorized_official_first_name": "SIMON",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "718-740-0710",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02724578",
            "state": "NY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00201583",
            "state": "NY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02573462",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Kyle Holder, OTR
• Whitney Quinn Hollins
• Hollis Advanced Dental Care P.C.
• Hollis Chemists LLC
• Hollis Drugs Inc
• Hollis Medical Office
• Hollis Medical PC
• Hollis Multi-Specialty Dental Group P.C
• Hollis Operating Co LLC (Holliswood Center for Rehabilitation and Healthcare)
• Hollis Park Manor Nursing Home, Inc.

• Surgery Physician in Hollis, NY
• Providers in Hollis, NY by specialty
• Surgery Physician in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 11, 2025; 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.