Organization Active NPI

Medical Associates, P.C.

  • Infectious Disease Physician
  • Elmhurst, NY
National Provider Identifier
1659539781
Registry record updated Nov 4, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Infectious Disease PhysicianTaxonomy code 207RI0200X
License
201321 Issued in NY
Legal business name
MEDICAL ASSOCIATES, P.C.
Practice address
8708 Justice Ave
Suite CS
Elmhurst, NY 11373-4575
Phone
(718) 779-9599
Fax
(718) 779-9579
NPI assigned
May 27, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 4, 2008

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

Authorized official

Name
Dr. Marie E Dy-Guillaume, MDNPI 1538123922
Title
President
Phone
(718) 779-9599

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Gastroenterology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207RG0100X 210261 NY
Infectious Disease PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207RI0200X 201321 NY Primary

Addresses

Primary practice location

8708 Justice Ave
Suite CS
Elmhurst, NY 11373-4575

Mailing address

8708 Justice Ave
Suite CS
Elmhurst, NY 11373-4575
Phone (718) 779-9599

Other identifiers 1

IdentifierTypeStateIssuer
03028379MedicaidNY

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20080811000089 NY Part B Supplier - Clinic/Group Practice 2264506179 Receives reassigned benefits from 2 practitioners
Practice locations: Elmhurst, NY

National Provider Directory

National Provider Directory

Locations

8708 Justice Ave
Ste Cs
Elmhurst, NY 11373
Phone (718) 779-9599

Practitioners & affiliated clinicians

Practitioners 3

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": "1211846400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1225756800000",
    "number": "1659539781",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8708 JUSTICE AVE",
            "address_2": "SUITE CS",
            "city": "ELMHURST",
            "state": "NY",
            "postal_code": "113734575",
            "telephone_number": "718-779-9599",
            "fax_number": "718-779-9579"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8708 JUSTICE AVE",
            "address_2": "SUITE CS",
            "city": "ELMHURST",
            "state": "NY",
            "postal_code": "113734575",
            "telephone_number": "718-779-9599",
            "fax_number": "718-779-9579"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MEDICAL ASSOCIATES, P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-05-27",
        "last_updated": "2008-11-04",
        "status": "A",
        "authorized_official_last_name": "DY-GUILLAUME",
        "authorized_official_first_name": "MARIE",
        "authorized_official_middle_name": "E",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "718-779-9599",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207RG0100X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "NY",
            "license": "210261",
            "primary": false
        },
        {
            "code": "207RI0200X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine, Infectious Disease",
            "state": "NY",
            "license": "201321",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "03028379",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Elmhurst, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 4, 2008; 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.