NPIMap

Organization Active NPI

Medical Office of Howard Beach, PC

  • Family Medicine Physician
  • Howard Beach, NY
National Provider Identifier
1669648887
Registry record updated May 7, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
MEDICAL OFFICE OF HOWARD BEACH, PC
Practice address
15640 Crossbay Blvd
Howard Beach, NY 11414-2745
Phone
(718) 529-4500
NPI assigned
May 7, 2008
Last updated
May 7, 2008By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 7, 2008

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

Authorized official

Name
Mary Pecorino
Title
Manager
Phone
(718) 529-4500

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X Primary

Addresses

Primary practice location

15640 Crossbay Blvd
Howard Beach, NY 11414-2745

Mailing address

15640 Crossbay Blvd
Howard Beach, NY 11414-2745
Phone (718) 529-4500

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20041222000791 NY Part B Supplier - Clinic/Group Practice 1759349624 Receives reassigned benefits from 4 practitioners
Practice locations: Howard Beach, NY

National Provider Directory

National Provider Directory
Tax ID family
Medical Office of Howard Beach2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Locations

15640 Crossbay Blvd
Howard Beach, NY 11414
Phone (516) 741-2255

15640 Crossbay Blvd
Ste 1
Howard Beach, NY 11414

Practitioners & affiliated clinicians

Practitioners 6

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": "1210118400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1210118400000",
    "number": "1669648887",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15640 CROSSBAY BLVD",
            "city": "HOWARD BEACH",
            "state": "NY",
            "postal_code": "114142745",
            "telephone_number": "718-529-4500"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15640 CROSSBAY BLVD",
            "city": "HOWARD BEACH",
            "state": "NY",
            "postal_code": "114142745",
            "telephone_number": "718-529-4500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MEDICAL OFFICE OF HOWARD BEACH, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-05-07",
        "last_updated": "2008-05-07",
        "status": "A",
        "authorized_official_last_name": "PECORINO",
        "authorized_official_first_name": "MARY",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "718-529-4500"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Howard Beach, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 7, 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.