NPIMap

Individual provider Active NPI

Oscar Jorge Fukilman, M.D.

  • Internal Medicine Physician
  • Astoria, NY
National Provider Identifier
1750307211
Registry record updated Jul 24, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
111279 Issued in NY
Practice address
25-31 30TH Road
Suite 1a
Astoria, NY 11102-2648
Phone
(718) 267-1102
Fax
(718) 267-0847
NPI assigned
Jul 15, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 24, 2024

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 111279 NY Primary

Addresses

Primary practice location

25-31 30TH Road
Suite 1a
Astoria, NY 11102-2648

Mailing address

25-31 30TH Road
Suite 1a
Astoria, NY 11102-2648
Phone (718) 267-1102

Other identifiers 1

IdentifierTypeStateIssuer
00199739MedicaidNY

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20090421000256 NY Practitioner - Internal Medicine 0547317026 Reassigns benefits to 1 organization
Practice locations: Astoria, NY

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 1968
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Somos Medical PCGroup PAC ID 6406217868, 10 clinicians

Practice addresses (Care Compare)

1030 Sheridan Ave
Bronx, NY 10456-6100
Phone (833) 717-2828

1150 Webster Ave
Bronx, NY 10456-1834
Phone (833) 717-2828

2531 30TH Rd
Suite 1a
Astoria, NY 11102-2624
Phone (833) 717-2828

44 Sherman Ave
New York, NY 10040-1104
Phone (833) 717-2828

571 Academy St
Apt 1a
New York, NY 10034-5105

610 Academy St
Suite 10a
New York, NY 10034-5058
Phone (833) 717-2828

620 W 190TH St
New York, NY 10040-4157
Phone (833) 717-2828

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Mount Sinai Hospital Past Accepting new patients
The Mount Sinai Hospital Past Accepting new patients

Networks

  • Healthfirst Medicare Network H5989
  • Healthfirst Medicare Network H1722
  • Healthfirst Medicare Network H3359
  • Healthfirst Medicare Network H9678

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 9

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1152921600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1721779200000",
    "number": "1750307211",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "25-31 30TH ROAD",
            "address_2": "SUITE 1A",
            "city": "ASTORIA",
            "state": "NY",
            "postal_code": "111022648",
            "telephone_number": "718-267-1102",
            "fax_number": "718-267-0847"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "25-31 30TH ROAD",
            "address_2": "SUITE 1A",
            "city": "ASTORIA",
            "state": "NY",
            "postal_code": "111022648",
            "telephone_number": "718-267-1102",
            "fax_number": "718-267-0847"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FUKILMAN",
        "first_name": "OSCAR",
        "middle_name": "JORGE",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-07-15",
        "last_updated": "2024-07-24",
        "certification_date": "2024-07-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NY",
            "license": "111279",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00199739",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Astoria, NY

Sources for this page

Verify at the official NPI Registry.