NPIMap

Organization Active NPI

Medrock Medical PC

  • Family Medicine Physician
  • New York, NY
National Provider Identifier
1801172085
Registry record updated Jan 16, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
177709-3 Issued in NY
Legal business name
MEDROCK MEDICAL PC
Practice address
109 E 36TH St
New York, NY 10016-3447
Phone
(212) 510-7020
Fax
(212) 510-7021
NPI assigned
Nov 1, 2011
Last updated
Jan 16, 2017By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 16, 2017

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

Authorized official

Name
Jeremie Rachunow, M.D.NPI 1518978634
Title
Officer
Phone
(212) 510-7020

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 3

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X X010496-1 NY
Family Medicine Physician 207Q00000X 220017-1 NY
Family Medicine Physician 207Q00000X 177709-3 NY Primary

Addresses

Primary practice location

109 E 36TH St
New York, NY 10016-3447

Mailing address

109 E 36TH St
New York, NY 10016-3447
Phone (212) 510-7020

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1320105600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1484524800000",
    "number": "1801172085",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "109 E 36TH ST",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100163447",
            "telephone_number": "212-510-7020",
            "fax_number": "212-510-7021"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "109 E 36TH ST",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100163447",
            "telephone_number": "212-510-7020",
            "fax_number": "212-510-7021"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MEDROCK MEDICAL PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-11-01",
        "last_updated": "2017-01-16",
        "status": "A",
        "authorized_official_last_name": "RACHUNOW",
        "authorized_official_first_name": "JEREMIE",
        "authorized_official_title_or_position": "OFFICER",
        "authorized_official_telephone_number": "212-510-7020",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "NY",
            "license": "X010496-1",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NY",
            "license": "220017-1",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NY",
            "license": "177709-3",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 16, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.