NPIMap

Organization Active NPI

New York Medical & Diagnostic Center Inc

  • Family Medicine Physician
  • Kew Gardens, NY
National Provider Identifier
1790771889
Registry record updated May 4, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
NEW YORK MEDICAL & DIAGNOSTIC CENTER INC
Practice address
8046 Kew Gardens Rd
Kew Gardens, NY 11415-1154
Phone
(718) 261-1000
Fax
(718) 261-0336
NPI assigned
Sep 23, 2005
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 4, 2016

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

Authorized official

Name
Dr. Jacob K Sadigh, D.C.
Title
Administrator
Phone
(718) 261-1000

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207Q00000X Primary
Internal Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207R00000X

Addresses

Primary practice location

8046 Kew Gardens Rd
Kew Gardens, NY 11415-1154

Mailing address

8046 Kew Gardens Rd
Kew Gardens, NY 11415-1154
Phone (718) 261-1000

Other identifiers 1

IdentifierTypeStateIssuer
0811930MedicaidNY

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20040326000518 NY Part B Supplier - Clinic/Group Practice 9436041217 Receives reassigned benefits from 44 practitioners
Practice locations: Kew Gardens, NY
O20100930058380 NY DME Supplier - Physician - General PracticeDME Supplier - Independently-Practicing Physical Therapist 9436041217 Practice locations: Kew Gardens, NY

National Provider Directory

National Provider Directory
Tax ID family
New York Medical and Diagnostic Center2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Locations

8046 Kew Gardens Rd
Kew Gardens, NY 11415
Phone (718) 261-1000

Practitioners & affiliated clinicians

Practitioners 46

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

View all 46

NPI Registry JSON

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

{
    "created_epoch": "1127433600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1462320000000",
    "number": "1790771889",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8046 KEW GARDENS RD",
            "city": "KEW GARDENS",
            "state": "NY",
            "postal_code": "114151154",
            "telephone_number": "718-261-1000",
            "fax_number": "718-261-0336"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8046 KEW GARDENS RD",
            "city": "KEW GARDENS",
            "state": "NY",
            "postal_code": "114151154",
            "telephone_number": "718-261-1000",
            "fax_number": "718-261-0336"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NEW YORK MEDICAL & DIAGNOSTIC CENTER INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-09-23",
        "last_updated": "2016-05-04",
        "status": "A",
        "authorized_official_last_name": "SADIGH",
        "authorized_official_first_name": "JACOB",
        "authorized_official_middle_name": "K",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "718-261-1000",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.C."
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0811930",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Kew Gardens, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 4, 2016; 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.