East Elmhurst Primary Medical Care, PLLC

Primary specialty

Sleep Medicine (Internal Medicine) PhysicianTaxonomy code 207RS0012X

License

180270 Issued in NY

Legal business name

EAST ELMHURST PRIMARY MEDICAL CARE, PLLC

Practice address

2008 Seagirt Blvd
Far Rockaway, NY 11691-2803

Phone

(718) 565-6880

Fax

(877) 796-4457

NPI assigned

May 26, 2006

Organization subpart

No

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

Authorized official

Name

Mr. Eric Jones

Title

Credentialing Specialist

Phone

(718) 233-9122

Specialties & licenses 2

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in NY

Enrollment records 1

Locations

Practitioners 2

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

• Mujibur R Majumder, MD

  • Pulmonary Disease Physician
  • Brooklyn, NY
  • NPI 1316988165

  Sleep Medicine

  Medicare reassignment NPD
• Robert Solomon, MD

  • Diagnostic Radiology Physician
  • Brooklyn, NY
  • NPI 1720050040
  Medicare reassignment NPD

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

{
    "created_epoch": "1148601600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1719878400000",
    "number": "1851347900",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2008 SEAGIRT BLVD",
            "city": "FAR ROCKAWAY",
            "state": "NY",
            "postal_code": "116912803",
            "telephone_number": "718-565-6880",
            "fax_number": "877-796-4457"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2008 SEAGIRT BLVD",
            "city": "FAR ROCKAWAY",
            "state": "NY",
            "postal_code": "116912803",
            "telephone_number": "718-565-6880",
            "fax_number": "877-796-4457"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "11622 Queens Blvd",
            "address_purpose": "LOCATION",
            "city": "Forest Hills",
            "state": "NY",
            "postal_code": "113757055",
            "country_code": "US",
            "telephone_number": "718-793-4000",
            "fax_number": "718-793-4100",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "EAST ELMHURST PRIMARY MEDICAL CARE, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-26",
        "last_updated": "2024-07-02",
        "certification_date": "2024-07-02",
        "status": "A",
        "authorized_official_last_name": "JONES",
        "authorized_official_first_name": "ERIC",
        "authorized_official_title_or_position": "CREDENTIALING SPECIALIST",
        "authorized_official_telephone_number": "718-233-9122",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": "NY",
            "license": "180270",
            "primary": false
        },
        {
            "code": "207RS0012X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine, Sleep Medicine",
            "state": "NY",
            "license": "180270",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01454842",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NYS MEDICAL LIC #",
            "identifier": "180270",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Anne-Kenya Dubuisson, MSED, MHC
• Edrist Duneant, M.D.
• Daniella Danika Dwarica-Baptiste
• Asher J. Dworetsky, LMSW
• Shruti Darshini Dyal, MS. ED; SPED
• Lori Ebert, MA CCC SLP
• Michael Edelstein
• Rebecca Edelstein, M.S.
• Alison Alexis Edinboro
• Elsie T Edme

• Sleep Medicine (Internal Medicine) Physician in Far Rockaway, NY
• Providers in Far Rockaway, NY by specialty
• Sleep Medicine (Internal Medicine) Physician in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 2, 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.

Verify at the official NPI Registry.