Phoenix Rises Medical Services, P.C.

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

Legal business name

PHOENIX RISES MEDICAL SERVICES, P.C.

Practice address

17541 Hillside Ave
Jamaica, NY 11432-5724

Phone

(718) 298-9500

Fax

(718) 658-0306

NPI assigned

Aug 13, 2019

Organization subpart

No

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

Authorized official

Name

Dr. Tomas Pattugalan, MD

Title

President/Owner

Phone

(718) 736-5749

Specialties & licenses 1

Addresses

Other identifiers 1

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

{
    "created_epoch": "1565654400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1565654400000",
    "number": "1750937082",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17541 HILLSIDE AVE",
            "city": "JAMAICA",
            "state": "NY",
            "postal_code": "114325724",
            "telephone_number": "718-298-9500",
            "fax_number": "718-658-0306"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17541 HILLSIDE AVE",
            "city": "JAMAICA",
            "state": "NY",
            "postal_code": "114325724",
            "telephone_number": "718-298-9500",
            "fax_number": "718-658-0306"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PHOENIX RISES MEDICAL SERVICES, P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-08-13",
        "last_updated": "2019-08-13",
        "status": "A",
        "authorized_official_last_name": "PATTUGALAN",
        "authorized_official_first_name": "TOMAS",
        "authorized_official_title_or_position": "PRESIDENT/OWNER",
        "authorized_official_telephone_number": "718-736-5749",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00726912",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Guerda Phillips
• Keith Alexander Phillips, D.D.S.
• Tracy Lee Phillips, D.D.S.
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• Phoenix Home Care Sercives, LLC
• Physician Medical Services, PC
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• Physiodynamics LLC
• Su Pann Phyu, PHARMD

• Internal Medicine Physician in Jamaica, NY
• Providers in Jamaica, 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 Aug 13, 2019; 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.