Organization Active NPI

Astoria Medical of New York, LLC

  • Vascular Surgery Physician
  • Astoria, NY
National Provider Identifier
1790156982
Registry record updated Oct 13, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Vascular Surgery PhysicianTaxonomy code 2086S0129X
Legal business name
ASTORIA MEDICAL OF NEW YORK, LLC
Practice address
3033 Steinway St
Astoria, NY 11103-3801
Phone
(718) 709-5329
Fax
(224) 246-8042
NPI assigned
Oct 13, 2015
Last updated
Oct 13, 2015By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 13, 2015

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

Authorized official

Name
Flora Katsnelson, MD
Title
Director
Phone
(847) 593-8460

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Vascular Surgery Physician 2086S0129X NU Primary

Addresses

Primary practice location

3033 Steinway St
Astoria, NY 11103-3801

Mailing address

PO Box 32
Northbrook, IL 60065-0032
Phone (847) 593-8460

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20180302000179 NY Part B Supplier - Clinic/Group Practice 8729349055 Receives reassigned benefits from 12 practitioners
Practice locations: Astoria, NY

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 15

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 15

NPI Registry JSON

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

{
    "created_epoch": "1444694400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1444694400000",
    "number": "1790156982",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 32",
            "city": "NORTHBROOK",
            "state": "IL",
            "postal_code": "600650032",
            "telephone_number": "847-593-8460",
            "fax_number": "224-246-8042"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3033 STEINWAY ST",
            "city": "ASTORIA",
            "state": "NY",
            "postal_code": "111033801",
            "telephone_number": "718-709-5329",
            "fax_number": "224-246-8042"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ASTORIA MEDICAL OF NEW YORK, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-10-13",
        "last_updated": "2015-10-13",
        "status": "A",
        "authorized_official_last_name": "KATSNELSON",
        "authorized_official_first_name": "FLORA",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "847-593-8460",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "2086S0129X",
            "taxonomy_group": "",
            "desc": "Surgery, Vascular Surgery",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Astoria, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 13, 2015; 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.