NPIMap

Organization Active NPI

Innovative Urology Practice of New York, PLLC

  • Urology Physician
  • Rego Park, NY
National Provider Identifier
1659782589
Registry record updated Jul 28, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Urology PhysicianTaxonomy code 208800000X
License
248604 Issued in NY
Legal business name
INNOVATIVE UROLOGY PRACTICE OF NEW YORK, PLLC
Practice address
92-29 Queens Blvd.
Suite 2B
Rego Park, NY 11374-1072
Phone
(718) 606-6912
Fax
(718) 606-6914
NPI assigned
May 14, 2014
Last updated
Jul 28, 2014By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 28, 2014

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

Authorized official

Name
Dr. Andrew I Fishman, M.D.NPI 1679839450
Title
Owner
Phone
(516) 455-1170

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Urology Physician 208800000X 248604 NY Primary

Addresses

Primary practice location

92-29 Queens Blvd.
Suite 2B
Rego Park, NY 11374-1072

Mailing address

92-29 Queens Blvd.
Suite 2B
Rego Park, NY 11374-1072
Phone (718) 606-6912

National Provider Directory

National Provider Directory

Locations

9320A Roosevelt Ave
#2
Jackson Heights, NY 11372
Phone (516) 455-1170

9229 Queens Blvd
Ste 2B
Rego Park, NY 11374
Phone (212) 434-3700

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/9248/brand/1/csg/1/fhir/r4

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1400025600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1406505600000",
    "number": "1659782589",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "92-29 QUEENS BLVD.",
            "address_2": "SUITE 2B",
            "city": "REGO PARK",
            "state": "NY",
            "postal_code": "113741072",
            "telephone_number": "718-606-6912",
            "fax_number": "718-606-6914"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "92-29 QUEENS BLVD.",
            "address_2": "SUITE 2B",
            "city": "REGO PARK",
            "state": "NY",
            "postal_code": "113741072",
            "telephone_number": "718-606-6912",
            "fax_number": "718-606-6914"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "INNOVATIVE UROLOGY PRACTICE OF NEW YORK, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-05-14",
        "last_updated": "2014-07-28",
        "status": "A",
        "authorized_official_last_name": "FISHMAN",
        "authorized_official_first_name": "ANDREW",
        "authorized_official_middle_name": "I",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "516-455-1170",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "208800000X",
            "taxonomy_group": "",
            "desc": "Urology",
            "state": "NY",
            "license": "248604",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Rego Park, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 28, 2014; 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.