Organization Active NPI

Refoua Medical P.C.

  • Internal Medicine Physician
  • Great Neck, NY
National Provider Identifier
1780155796
Registry record updated Dec 17, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
Legal business name
REFOUA MEDICAL P.C.
Practice address
935 Northern Blvd Ste 105
Great Neck, NY 11021-5309
Phone
(516) 487-0070
Fax
(516) 487-0072
NPI assigned
Dec 17, 2018
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 17, 2018

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

Authorized official

Name
Dr. Daniel D Refoua, DONPI 1598146383
Title
DO
Phone
(516) 974-3962

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207R00000X Primary

Addresses

Primary practice location

935 Northern Blvd Ste 105
Great Neck, NY 11021-5309

Mailing address

12 Willow PL
Great Neck, NY 11021-1906
Phone (914) 509-5836

Other identifiers 1

IdentifierTypeStateIssuer
05231136MedicaidNY

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20190131001007 NY Part B Supplier - Clinic/Group Practice 6406193317 Receives reassigned benefits from 2 practitioners
Practice locations: Great Neck, NY

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 2

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

NPI Registry JSON

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

{
    "created_epoch": "1545004800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1545004800000",
    "number": "1780155796",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12 WILLOW PL",
            "city": "GREAT NECK",
            "state": "NY",
            "postal_code": "110211906",
            "telephone_number": "914-509-5836",
            "fax_number": "914-357-2489"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "935 NORTHERN BLVD STE 105",
            "city": "GREAT NECK",
            "state": "NY",
            "postal_code": "110215309",
            "telephone_number": "516-487-0070",
            "fax_number": "516-487-0072"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "REFOUA MEDICAL P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-12-17",
        "last_updated": "2018-12-17",
        "status": "A",
        "authorized_official_last_name": "REFOUA",
        "authorized_official_first_name": "DANIEL",
        "authorized_official_middle_name": "D",
        "authorized_official_title_or_position": "DO",
        "authorized_official_telephone_number": "516-974-3962",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DO"
    },
    "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": "05231136",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Great Neck, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 17, 2018; 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.