Axiom Medical PC

Primary specialty

General Practice PhysicianTaxonomy code 208D00000X

License

220943 Issued in NY

Legal business name

AXIOM MEDICAL PC

Practice address

9602 Avenue L
Brooklyn, NY 11236-4813

Phone

(718) 444-0437

Fax

(718) 763-1267

NPI assigned

Jun 14, 2013

Organization subpart

No

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

Authorized official

Name

Daniel Dume-Charles, MD

Title

Owner

Phone

(718) 444-0437

Specialties & licenses 1

Addresses

Other identifiers 2

Interoperability endpoints

• FHIR API: https://fhir4.healow.com/fhir/r4/EHGBBD

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

{
    "created_epoch": "1371168000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1663545600000",
    "number": "1689013443",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "842 VAN BUREN ST",
            "city": "BALDWIN",
            "state": "NY",
            "postal_code": "115104652",
            "telephone_number": "718-444-0437",
            "fax_number": "718-763-1267"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9602 AVENUE L",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112364813",
            "telephone_number": "718-444-0437",
            "fax_number": "718-763-1267"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "AXIOM MEDICAL PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-06-14",
        "last_updated": "2022-09-19",
        "certification_date": "2022-09-19",
        "status": "A",
        "authorized_official_last_name": "DUME-CHARLES",
        "authorized_official_first_name": "DANIEL",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "718-444-0437",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "General Practice",
            "state": "NY",
            "license": "220943",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "03629696",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NY LICENSE",
            "identifier": "220943",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• General Practice Physician in Brooklyn, NY
• Providers in Brooklyn, NY by specialty
• General Practice Physician in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 19, 2022; 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.