Individual provider Active NPI

Vincent Sam Chow, FNP-BC

  • Family Nurse Practitioner
  • Flushing, NY
National Provider Identifier
1790519817
Registry record updated Nov 29, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
354360 Issued in NY
Practice address
11919 Graham CT
Flushing, NY 11354-1047
Phone
(718) 886-0700
NPI assigned
Aug 30, 2024
Last updated
Nov 29, 2024By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 29, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 354360 NY Primary

Addresses

Primary practice location

11919 Graham CT
Flushing, NY 11354-1047

Mailing address

13105 40TH Rd PH 1G
Flushing, NY 11354-5260

Other practice location 1

13105 40th Rd Ph 1G
Flushing, NY 11354-5260
Phone (347) 326-3177

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250123000814 NY Practitioner - Nurse Practitioner 4486183258 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2024
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Silver Star Medical Association of NJ PCGroup PAC ID 9234597402, 10 clinicians
Ilm Medical Care PLLCGroup PAC ID 2769610989, 37 clinicians

Practice addresses (Care Compare)

200 Lafayette Ave
Staten Island, NY 10301-1219
Phone (845) 738-8770

353 Beach 48TH St
Far Rockaway, NY 11691-1120
Phone (718) 471-5000

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Ilm Medical Care PLLC CurrentSince Nov 6, 2024 Accepting new patients
Silver Star Medical Association of NJ PC CurrentSince Jan 26, 2026 Accepting new patients

Locations

600 E Crescent Ave
Ste 305
Upper Saddle River, NJ 07458

2975 Independence Ave
Bronx, NY 10463
Phone (718) 542-1700

4646 Fairport Nine Mile Point Rd
Fairport, NY 14450
Phone (585) 377-0350

353 Beach 48th St
Far Rockaway, NY 11691
Phone (718) 471-5000

11919 Graham Ct
Flushing, NY 11354
Phone (718) 552-1000

200 Lafayette Ave
Staten Island, NY 10301
Phone (718) 448-9000

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1724976000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1732838400000",
    "number": "1790519817",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13105 40TH RD PH 1G",
            "city": "FLUSHING",
            "state": "NY",
            "postal_code": "113545260"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11919 GRAHAM CT",
            "city": "FLUSHING",
            "state": "NY",
            "postal_code": "113541047",
            "telephone_number": "718-886-0700"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "13105 40th Rd Ph 1G",
            "address_purpose": "LOCATION",
            "city": "Flushing",
            "state": "NY",
            "postal_code": "113545260",
            "country_code": "US",
            "telephone_number": "347-326-3177",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CHOW",
        "first_name": "VINCENT",
        "middle_name": "SAM",
        "name_prefix": "Mr.",
        "credential": "FNP-BC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2024-08-30",
        "last_updated": "2024-11-29",
        "certification_date": "2024-11-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NY",
            "license": "354360",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Flushing, NY

Sources for this page

Verify at the official NPI Registry.