NPIMap

Organization Active NPI

Edgar Flores-Castillo, MD PC

Doing business as Pediatric Plaza

  • Pediatrics Physician
  • Elmhurst, NY
National Provider Identifier
1669735031
Registry record updated Jun 20, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
211365 Issued in NY
Legal business name
EDGAR FLORES-CASTILLO, MD PC
Doing business as
Pediatric Plaza
Practice address
4053 75TH St
Elmhurst, NY 11373-1011
Phone
(718) 426-6270
Fax
(718) 426-6341
NPI assigned
Jun 20, 2012
Last updated
Jun 20, 2012By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 20, 2012

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

Authorized official

Name
Dr. Edgar Antonio Flores-Castillo, MDNPI 1396715850
Title
President
Phone
(718) 426-6270

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 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 211365 NY Primary

Addresses

Primary practice location

4053 75TH St
Elmhurst, NY 11373-1011

Mailing address

4053 75TH St
Elmhurst, NY 11373-1011
Phone (718) 426-6270

Other identifiers 1

IdentifierTypeStateIssuer
01867376MedicaidNY

Other names 1

  • Pediatric Plaza Doing business as

National Provider Directory

National Provider Directory

Locations

4053 75th St
Flushing, NY 11373
Phone (718) 426-6270

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": "1340150400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1340150400000",
    "number": "1669735031",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4053 75TH ST",
            "city": "ELMHURST",
            "state": "NY",
            "postal_code": "113731011",
            "telephone_number": "718-426-6270",
            "fax_number": "718-426-6341"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4053 75TH ST",
            "city": "ELMHURST",
            "state": "NY",
            "postal_code": "113731011",
            "telephone_number": "718-426-6270",
            "fax_number": "718-426-6341"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EDGAR FLORES-CASTILLO, MD PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-06-20",
        "last_updated": "2012-06-20",
        "status": "A",
        "authorized_official_last_name": "FLORES-CASTILLO",
        "authorized_official_first_name": "EDGAR",
        "authorized_official_middle_name": "ANTONIO",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "718-426-6270",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "NY",
            "license": "211365",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01867376",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Pediatric Plaza",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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 Jun 20, 2012; 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.