Active NPI
Abc Medical PC
- Internist Chiropractor
- Astoria, NY
National Provider Identifier
1801093166
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Internist Chiropractor
- Legal business name
- ABC MEDICAL PC
- Practice address
- 2126 Broadway
Astoria, NY 11106-4533 - Phone
- (718) 932-1700
- NPI assigned
- Jun 29, 2007
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Rose Santana
- Title
- Medical Assistant
- Phone
- (718) 932-1700
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Internist Chiropractor | 111NI0900X | Primary |
Addresses
Primary practice location
2126 Broadway
Astoria, NY 11106-4533
Mailing address
2126 Broadway
Astoria, NY 11106-4533
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 01134023 | Medicaid | NY |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in NY
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20120113000241 | NY | Part B Supplier - Clinic/Group Practice | 5890962963 |
Receives reassigned benefits from 1 practitioner Practice locations: Astoria, NY |
National Provider Directory
National Provider DirectoryPractitioners & affiliated clinicians
Practitioners 1
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": "1183075200000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1707955200000",
"number": "1801093166",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2126 BROADWAY",
"city": "ASTORIA",
"state": "NY",
"postal_code": "111064533"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2126 BROADWAY",
"city": "ASTORIA",
"state": "NY",
"postal_code": "111064533",
"telephone_number": "718-932-1700"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "ABC MEDICAL PC",
"organizational_subpart": "NO",
"enumeration_date": "2007-06-29",
"last_updated": "2024-02-15",
"certification_date": "2024-02-15",
"status": "A",
"authorized_official_last_name": "SANTANA",
"authorized_official_first_name": "ROSE",
"authorized_official_title_or_position": "MEDICAL ASSISTANT",
"authorized_official_telephone_number": "718-932-1700"
},
"taxonomies": [
{
"code": "111NI0900X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Chiropractor, Internist",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "01134023",
"state": "NY"
}
],
"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 Feb 15, 2024; 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.