Individual provider Active NPI

Igor Israel, M.D.

  • Internal Medicine Physician
  • Forest Hills, NY
National Provider Identifier
1851391692
Registry record updated Nov 3, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
221146 Issued in NY
Practice address
11241 Queens Blvd
Suite LLB
Forest Hills, NY 11375-7475
Phone
(718) 520-7723
Fax
(718) 520-7733
NPI assigned
Jul 22, 2005
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 3, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 221146 NY Primary

Addresses

Primary practice location

11241 Queens Blvd
Suite LLB
Forest Hills, NY 11375-7475

Mailing address

9925 65TH Rd
Rego Park, NY 11374-3654
Phone (718) 459-6505

Other identifiers 1

IdentifierTypeStateIssuer
02172223MedicaidNY

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050122000176 NY Practitioner - Internal Medicine 8325098825 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 1982
Medicare assignment
May accept Medicare assignment
Telehealth
Offers telehealth services
Group practices
I and R Medical Services, PCGroup PAC ID 9436109931, 2 clinicians

Practice addresses (Care Compare)

112 -41 Queens Blvd LLB
Forest Hills, NY 11375-5564
Phone (718) 520-7713

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
221146NYMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
I & R Medical Services PC Internal Medicine CurrentSince Sep 19, 2004 Accepting new patients
Care Connect Medical P.C. Internal Medicine CurrentSince Feb 1, 2024 Accepting new patients
Parker Jewish Institute for Health Care and Rehabilitation Past Accepting new patients

Locations

3090 Bristol St
Ste 200
Costa Mesa, CA 92626
Phone (714) 992-1182

6260 108th St
Ste 1J
Forest Hills, NY 11375

11241 Queens Blvd
Ste Llb
Forest Hills, NY 11375
Phone (718) 261-1759

7 Skyline Dr
Ste 250
Hawthorne, NY 10532

Networks

  • Healthfirst Medicare Network H5989
  • Healthfirst Medicare Network H3359
  • Healthfirst Medicare Network H1722

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1121990400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1446508800000",
    "number": "1851391692",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9925 65TH RD",
            "city": "REGO PARK",
            "state": "NY",
            "postal_code": "113743654",
            "telephone_number": "718-459-6505",
            "fax_number": "718-459-4247"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11241 QUEENS BLVD",
            "address_2": "SUITE LLB",
            "city": "FOREST HILLS",
            "state": "NY",
            "postal_code": "113757475",
            "telephone_number": "718-520-7723",
            "fax_number": "718-520-7733"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ISRAEL",
        "first_name": "IGOR",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-07-22",
        "last_updated": "2015-11-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NY",
            "license": "221146",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02172223",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Forest Hills, NY

Sources for this page

Verify at the official NPI Registry.