NPIMap

Organization Active NPI

Myrtle Ave Medical PLLC

  • Internal Medicine Physician
  • Glendale, NY
National Provider Identifier
1831069061
Registry record updated Nov 11, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
Legal business name
MYRTLE AVE MEDICAL PLLC
Practice address
6513 Myrtle Ave
Glendale, NY 11385-6248
Phone
(718) 456-3399
Fax
(718) 456-5741
NPI assigned
Nov 11, 2025
Last updated
Nov 11, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 11, 2025

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

Authorized official

Name
Myo Win, MDNPI 1881824829
Title
Owner
Phone
(917) 371-3703

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 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207R00000X Primary

Addresses

Primary practice location

6513 Myrtle Ave
Glendale, NY 11385-6248

Mailing address

5627 138TH St
Flushing, NY 11355-5039
Phone (917) 371-3703

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 13

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 13

NPI Registry JSON

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

{
    "created_epoch": "1762819200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1762819200000",
    "number": "1831069061",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5627 138TH ST",
            "city": "FLUSHING",
            "state": "NY",
            "postal_code": "113555039",
            "telephone_number": "917-371-3703"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6513 MYRTLE AVE",
            "city": "GLENDALE",
            "state": "NY",
            "postal_code": "113856248",
            "telephone_number": "718-456-3399",
            "fax_number": "718-456-5741"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MYRTLE AVE MEDICAL PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-11-11",
        "last_updated": "2025-11-11",
        "certification_date": "2025-11-11",
        "status": "A",
        "authorized_official_last_name": "WIN",
        "authorized_official_first_name": "MYO",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "917-371-3703",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Glendale, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 11, 2025; 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.