Organization Active NPI

Statmd Physicians, PLLC

  • Emergency Care Clinic/Center
  • New Hyde Park, NY
National Provider Identifier
1710020417
Registry record updated Mar 8, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Care Clinic/CenterTaxonomy code 261QE0002X
Legal business name
STATMD PHYSICIANS, PLLC
Practice address
2090 Jericho Tpke
New Hyde Park, NY 11040-4719
Phone
(516) 352-7828
Fax
(516) 352-7827
NPI assigned
Feb 14, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 8, 2022

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

Authorized official

Name
Ms. Safia Huda
Title
Office Manager
Phone
(516) 352-7828

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Care Clinic/Center 261QE0002X Primary

Addresses

Primary practice location

2090 Jericho Tpke
New Hyde Park, NY 11040-4719

Mailing address

2090 Jericho Tpke
New Hyde Park, NY 11040-4719
Phone (516) 352-7828

Other names 1

  • StatMD Other name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20050414001182 NY Part B Supplier - Clinic/Group Practice 8820035439 Receives reassigned benefits from 11 practitioners
Practice locations: New Hyde Park, NY
O20101111000052 NY Part B Supplier - Clinic/Group Practice 0648465039 Receives reassigned benefits from 871 practitioners
This NPI is an additional NPI on the enrollment

Laboratory certificates & supplier records

Derived by NPIMap

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

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
33D1034831Statmd Physicians, PLLC2090 Jericho Turnpike, New Hyde Park, NY 11040Certificate of waiverJun 24, 2027

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 14

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.

View all 14

NPI Registry JSON

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

{
    "created_epoch": "1171411200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1646697600000",
    "number": "1710020417",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2090 JERICHO TPKE",
            "city": "NEW HYDE PARK",
            "state": "NY",
            "postal_code": "110404719",
            "telephone_number": "516-352-7828",
            "fax_number": "516-352-7827"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2090 JERICHO TPKE",
            "city": "NEW HYDE PARK",
            "state": "NY",
            "postal_code": "110404719",
            "telephone_number": "516-352-7828",
            "fax_number": "516-352-7827"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "STATMD PHYSICIANS, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-14",
        "last_updated": "2022-03-08",
        "certification_date": "2022-03-08",
        "status": "A",
        "authorized_official_last_name": "HUDA",
        "authorized_official_first_name": "SAFIA",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "516-352-7828",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "261QE0002X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Emergency Care",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "StatMD",
            "code": "5",
            "type": "Other Name"
        },
        {
            "organization_name": "StatMD",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in New Hyde Park, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 8, 2022; 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.