Queens Medical of New York LLC

Primary specialty

Vascular Surgery PhysicianTaxonomy code 2086S0129X

Legal business name

QUEENS MEDICAL OF NEW YORK LLC

Practice address

11602 Queens Blvd
Forest Hills, NY 11375-7055

Phone

(718) 301-1100

Fax

(888) 621-3330

NPI assigned

Sep 17, 2012

Last updated

Sep 17, 2012By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Flora Katsnelson, MD

Title

Owner

Phone

(718) 301-1100

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Enrolled in NY

Enrollment records 1

Locations

Practitioners 8

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.

• Richard Di Fiore, MD

  • Vascular Surgery Physician
  • Astoria, NY
  • NPI 1902000995
  Medicare reassignment Care Compare group
• Alexander Gart, MD

  • Vascular Surgery Physician
  • New York, NY
  • NPI 1376610758
  Medicare reassignment Care Compare group
• Jeromy Ryan Patterson, M.D.

  • Surgery Physician
  • Forest Hills, NY
  • NPI 1770877953
  Medicare reassignment Care Compare group
• Robert Shirinov

  • Surgery Physician
  • Sleepy Hollow, NY
  • NPI 1902067986
  Medicare reassignment Care Compare group
• John Babalola, M.D.

  • Surgery Physician
  • Valley Stream, NY
  • NPI 1487613626
  Medicare reassignment NPD
• J Timothy Riley, M D

  • Vascular Surgery Physician
  • Syracuse, NY
  • NPI 1609076629
  Medicare reassignment NPD
• Glenn Rory Faust, MD

  • Vascular Surgery Physician
  • East Meadow, NY
  • NPI 1003986456
  NPD (past)
• Matthew Yongwon Suh, MD

  • Surgical Oncology Physician
  • Newton, NJ
  • NPI 1720085707
  NPD (past)

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

{
    "created_epoch": "1347840000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1347840000000",
    "number": "1730439704",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 32",
            "city": "NORTHBROOK",
            "state": "IL",
            "postal_code": "600650032",
            "telephone_number": "718-301-1100",
            "fax_number": "888-621-3330"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11602 QUEENS BLVD",
            "city": "FOREST HILLS",
            "state": "NY",
            "postal_code": "113757055",
            "telephone_number": "718-301-1100",
            "fax_number": "888-621-3330"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "QUEENS MEDICAL OF NEW YORK LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-09-17",
        "last_updated": "2012-09-17",
        "status": "A",
        "authorized_official_last_name": "KATSNELSON",
        "authorized_official_first_name": "FLORA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "718-301-1100",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2085R0204X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Radiology, Vascular & Interventional Radiology",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2086S0129X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Surgery, Vascular Surgery",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Queens Community House, Inc.
• Queens Family Medical Health and Wellness, PC
• Queens Hematology Oncology PC
• Queens Medical Imaging, PC
• Queens Medical Imaging, PC
• Queens Medical Pavilion,LLC (Ny Med)
• Queens Nephrology Care PC
• Queens Physical Therapy Associates LLP
• Queens Professional Medical Services of New York LLC
• Emelyn C Quijano, MD

• Vascular Surgery Physician in Forest Hills, NY
• Providers in Forest Hills, NY by specialty
• Vascular Surgery Physician in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 17, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.