Tri City Medical PC

Primary specialty

Gastroenterology PhysicianTaxonomy code 207RG0100X

Legal business name

TRI CITY MEDICAL PC

Practice address

5812 Queens Blvd # 21281
Woodside, NY 11377-7765

Phone

(929) 224-2588

Fax

(917) 818-4288

NPI assigned

Feb 16, 2022

Organization subpart

No

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

Authorized official

Name

Jin Lee

Title

Administrator

Phone

(929) 224-2588

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in NY

Enrollment records 1

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Michael Khaham, D.O., RPH

  • Anesthesiology Physician
  • Brooklyn, NY
  • NPI 1790985596
  NPD (past)

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

{
    "created_epoch": "1644969600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1747612800000",
    "number": "1639824816",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5812 QUEENS BLVD # 21281",
            "city": "WOODSIDE",
            "state": "NY",
            "postal_code": "113777765",
            "telephone_number": "929-224-2588",
            "fax_number": "917-818-4288"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5812 QUEENS BLVD # 21281",
            "city": "WOODSIDE",
            "state": "NY",
            "postal_code": "113777765",
            "telephone_number": "929-224-2588",
            "fax_number": "917-818-4288"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TRI CITY MEDICAL PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-02-16",
        "last_updated": "2025-05-19",
        "certification_date": "2025-05-19",
        "status": "A",
        "authorized_official_last_name": "LEE",
        "authorized_official_first_name": "JIN",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "929-224-2588"
    },
    "taxonomies": [
        {
            "code": "207RG0100X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine, Gastroenterology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Quasheema Torrellas, PTA
• Serafin Torres, LMSW
• Nour Najeh Trabilsy, RPH
• Vincent Tran
• Elizabeth R. Traverso
• Triborough Gastroenterology PC
• Rachel Leigh Trotti
• True Light Missions Inc (True Light Adult Day Care Center)
• Tsering Tsomo, LPN
• Adolphus Tubianosa

• Gastroenterology Physician in Woodside, NY
• Providers in Woodside, NY by specialty
• Gastroenterology Physician in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 19, 2025; 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.