Broadway I Medicine PLLC

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

254371 Issued in NY

Legal business name

BROADWAY I MEDICINE PLLC

Practice address

4250 Broadway RM 1a
New York, NY 10033-3749

Phone

(212) 740-7100

Fax

(212) 740-8232

NPI assigned

Mar 26, 2010

Organization subpart

No

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

Authorized official

Name

Dr. Jose F Perez, M.D.NPI 1245255611

Title

Physician

Phone

(212) 740-7100

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in NY

Enrollment records 1

Locations

Practitioners 5

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

• Jose Francisco Perez, M.D.

  • Pediatrics Physician
  • New York, NY
  • NPI 1245255611
  Medicare reassignment NPD Authorized official
• Paul Joseph Avvocato, MD

  • Internal Medicine Physician
  • Port Chester, NY
  • NPI 1760527931
  Medicare reassignment NPD
• Maxwell Johann Kissel, MD

  • Internal Medicine Physician
  • New York, NY
  • NPI 1346982584
  Medicare reassignment NPD
• Mirza E Morales-Diaz, M.D.

  • Emergency Medicine Physician
  • Harriman, TN
  • NPI 1568568723

  NY

  Medicare reassignment NPD
• Yomaris Mercedes Pena Pena, MD

  • Internal Medicine Physician
  • New York, NY
  • NPI 1457509762
  NPD (past)

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

{
    "created_epoch": "1269561600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1607472000000",
    "number": "1740504240",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4250 BROADWAY RM 1A",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100333749",
            "telephone_number": "212-740-7100",
            "fax_number": "212-740-8232"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4250 BROADWAY RM 1A",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100333749",
            "telephone_number": "212-740-7100",
            "fax_number": "212-740-8232"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BROADWAY I MEDICINE PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-03-26",
        "last_updated": "2020-12-09",
        "certification_date": "2020-12-09",
        "status": "A",
        "authorized_official_last_name": "PEREZ",
        "authorized_official_first_name": "JOSE",
        "authorized_official_middle_name": "F",
        "authorized_official_title_or_position": "PHYSICIAN",
        "authorized_official_telephone_number": "212-740-7100",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine",
            "state": "NY",
            "license": "254371",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Broadway Chiropractic Associates
• Broadway Denatl Care, PC
• Broadway Dental Office, P.C
• Broadway Downtown Pharmacy Inc.
• Broadway GYN Office, P.C
• Broadway Manhattan Medical Office, PC
• Broadway Pediatrics M.D.P.C.
• Broadway Pharmacy III Inc
• Broadway Pharmacy Nyc Inc
• Broadway RX Enterprises Inc

• Internal Medicine Physician in New York, NY
• Providers in New York, 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 Dec 9, 2020; 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.