Carol Sasportas MD LLC

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

195407 Issued in NY

Legal business name

CAROL SASPORTAS MD LLC

Practice address

7568 187TH St
Fresh Meadows, NY 11366-1726

Phone

(718) 454-2500

Fax

(718) 454-8500

NPI assigned

Sep 4, 2008

Organization subpart

No

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

Authorized official

Name

Dr. Carol Sasportas, MD

Title

Owner Physician

Phone

(718) 454-2500

Specialties & licenses 1

Addresses

Other identifiers 2

Locations

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

{
    "created_epoch": "1220486400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1340668800000",
    "number": "1720236516",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7568 187TH ST",
            "city": "FRESH MEADOWS",
            "state": "NY",
            "postal_code": "113661726",
            "telephone_number": "718-454-2500",
            "fax_number": "718-454-8500"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7568 187TH ST",
            "city": "FRESH MEADOWS",
            "state": "NY",
            "postal_code": "113661726",
            "telephone_number": "718-454-2500",
            "fax_number": "718-454-8500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CAROL SASPORTAS MD LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-09-04",
        "last_updated": "2012-06-26",
        "status": "A",
        "authorized_official_last_name": "SASPORTAS",
        "authorized_official_first_name": "CAROL",
        "authorized_official_title_or_position": "OWNER PHYSICIAN",
        "authorized_official_telephone_number": "718-454-2500",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine",
            "state": "NY",
            "license": "195407",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE ID TYPE UNSPECIFIED",
            "identifier": "001SF1",
            "state": "NY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02573462",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Internal Medicine Physician in Fresh Meadows, NY
• Providers in Fresh Meadows, 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 Jun 26, 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.