Active NPI
Maria Homer
- Pediatric Adolescent Medicine Physician
- Elmhurst, NY
National Provider Identifier
1760567309
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatric Adolescent Medicine Physician
- License
- 135840
- Practice address
- 9429 59TH Ave
Elmhurst, NY 11373-5150 - Phone
- (718) 271-7400
- Fax
- (718) 271-4321
- NPI assigned
- Oct 25, 2006
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatric Adolescent Medicine Physician | 2080A0000X | 135840 | NY | Primary |
Addresses
Primary practice location
9429 59TH Ave
Elmhurst, NY 11373-5150
Mailing address
22 Whitson St
Forest Hills, NY 11375-6852
Phone (718) 263-5364
Other identifiers 13
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1C4455 | Other | NY | HEALTHNET PROV ID |
| 00315586 | Medicaid | NY | |
| P434947 | Other | NY | OXFORD HEALTH PLAN PROVID |
| 31036732 | Other | NY | LABCORP PROV ID |
| 04894 | Other | NY | QUEST LABS PROV ID |
| 135840A17 | Other | NY | HF 1199 HOME CARE PROV ID |
| 1831X01 | Other | NY | NYC DEPT OF HEALTH ID |
| 0085974 | Other | NY | GHI PROVIDER ID |
| 16A361 | Other | NY | EMPIRE BC&BS PROV ID |
| 135840N01 | Other | NY | HIP PROVIDER ID |
| 54460N | Other | CIGNA PROV ID | |
| 1073280001 &12-01215 | Other | NY | UNITED HEALTHCARE PROV ID |
| 135840 | Other | NY | MEDICAL LICENSE |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 135840 | NY | MD | Pediatric Adolescent Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| TJH Medical Services, P.C. | Past | Accepting new patients |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
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NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1161734400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1678147200000",
"number": "1760567309",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "22 WHITSON ST",
"city": "FOREST HILLS",
"state": "NY",
"postal_code": "113756852",
"telephone_number": "718-263-5364"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "9429 59TH AVE",
"city": "ELMHURST",
"state": "NY",
"postal_code": "113735150",
"telephone_number": "718-271-7400",
"fax_number": "718-271-4321"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HOMER",
"first_name": "MARIA",
"name_prefix": "Dr.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2006-10-25",
"last_updated": "2023-03-07",
"status": "A"
},
"taxonomies": [
{
"code": "2080A0000X",
"taxonomy_group": "",
"desc": "Pediatrics, Adolescent Medicine",
"state": "NY",
"license": "135840",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "HEALTHNET PROV ID",
"identifier": "1C4455",
"state": "NY"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "00315586",
"state": "NY"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "OXFORD HEALTH PLAN PROVID",
"identifier": "P434947",
"state": "NY"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "LABCORP PROV ID",
"identifier": "31036732",
"state": "NY"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "QUEST LABS PROV ID",
"identifier": "04894",
"state": "NY"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "HF 1199 HOME CARE PROV ID",
"identifier": "135840A17",
"state": "NY"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "NYC DEPT OF HEALTH ID",
"identifier": "1831X01",
"state": "NY"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "GHI PROVIDER ID",
"identifier": "0085974",
"state": "NY"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "EMPIRE BC&BS PROV ID",
"identifier": "16A361",
"state": "NY"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "HIP PROVIDER ID",
"identifier": "135840N01",
"state": "NY"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "CIGNA PROV ID",
"identifier": "54460N",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "UNITED HEALTHCARE PROV ID",
"identifier": "1073280001 &12-01215",
"state": "NY"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MEDICAL LICENSE",
"identifier": "135840",
"state": "NY"
}
],
"endpoints": [],
"other_names": []
}Other providers in Elmhurst, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 7, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.