Corona Medical PC

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

Legal business name

CORONA MEDICAL PC

Practice address

40-11 Warren St
2ND Floor
Elmhurst, NY 11373-1700

Phone

(718) 426-8100

Fax

(718) 396-0407

NPI assigned

Sep 21, 2012

Organization subpart

No

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

Authorized official

Name

Dr. Afshin Tavakoly, M.D.NPI 1700059680

Title

Officer/Physician

Phone

(917) 605-7233

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in NY

Enrollment records 1

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Locations

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Afshin Tavakoly, M.D.

  • Internal Medicine Physician
  • Brooklyn, NY
  • NPI 1700059680
  Medicare reassignment Care Compare group Authorized official
• Sharon Kheradnam

  • Internal Medicine Physician
  • Brooklyn, NY
  • NPI 1063823664
  Medicare reassignment Care Compare group NPD
• Miriam Tavakoly

  • Physician Assistant
  • Brooklyn, NY
  • NPI 1710247192
  Medicare reassignment Care Compare group

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

{
    "created_epoch": "1348185600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1730246400000",
    "number": "1699026385",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 650067",
            "city": "FRESH MEADOWS",
            "state": "NY",
            "postal_code": "113650067",
            "telephone_number": "917-605-7233",
            "fax_number": "718-998-4252"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "40-11 WARREN ST",
            "address_2": "2ND FLOOR",
            "city": "ELMHURST",
            "state": "NY",
            "postal_code": "113731700",
            "telephone_number": "718-426-8100",
            "fax_number": "718-396-0407"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CORONA MEDICAL PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-09-21",
        "last_updated": "2024-10-30",
        "certification_date": "2024-10-24",
        "status": "A",
        "authorized_official_last_name": "TAVAKOLY",
        "authorized_official_first_name": "AFSHIN",
        "authorized_official_title_or_position": "OFFICER/PHYSICIAN",
        "authorized_official_telephone_number": "917-605-7233",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "207V00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Obstetrics & Gynecology",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Isabel Contreras, M.A.
• Andrew McCormick Cook, PA-C
• Fabio G Cordero, DDS
• Core Care PT PC
• George Nicholas Coritsidis, MD
• Kendryll Corpus
• Catherine Corrado-Lodi, OTR/L
• Gimbo John Obfenda Corre, PT
• Julie Cortes
• Awilda Cortez Ben-Melech

• Internal Medicine Physician in Elmhurst, NY
• Providers in Elmhurst, NY by specialty
• Internal Medicine Physician in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 30, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.