Individual provider Active NPI

Allen C Small, M.D.

  • Internal Medicine Physician
  • Kew Gardens, NY
National Provider Identifier
1699716274
Registry record updated Apr 30, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
145789 Issued in NY
Practice address
8046 Kew Gardens Rd
Kew Gardens, NY 11415-1154
Phone
(718) 261-1000
Fax
(718) 261-0336
NPI assigned
Jun 8, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 30, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 145789 NY Primary

Addresses

Primary practice location

8046 Kew Gardens Rd
Kew Gardens, NY 11415-1154

Mailing address

4 Irving PL
FL 11
New York, NY 10003-3502
Phone (718) 261-1000

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20200610002336 NY Order and Referring Only - Internal MedicinePractitioner - Internal Medicine 9638258544

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

NPI Registry JSON

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

{
    "created_epoch": "1149724800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1588204800000",
    "number": "1699716274",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4 IRVING PL",
            "address_2": "FL 11",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100033502",
            "telephone_number": "718-261-1000",
            "fax_number": "718-261-0336"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8046 KEW GARDENS RD",
            "city": "KEW GARDENS",
            "state": "NY",
            "postal_code": "114151154",
            "telephone_number": "718-261-1000",
            "fax_number": "718-261-0336"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMALL",
        "first_name": "ALLEN",
        "middle_name": "C",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-08",
        "last_updated": "2020-04-30",
        "certification_date": "2020-04-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NY",
            "license": "145789",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Kew Gardens, NY

Sources for this page

Verify at the official NPI Registry.