Kasem Angkustsiri, M.D.

Primary specialty

Anatomic Pathology & Clinical Pathology PhysicianTaxonomy code 207ZP0102X

License

122132 Issued in NY

Practice address

90 02 Queens Blvd
Elmhurst, NY 11373

Phone

(718) 558-1720

Fax

(718) 558-1783

NPI assigned

Jan 3, 2007

Last updated

Jul 8, 2007By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

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

• CMC Housestaff

  dba St Vincents Catholic Medical Center

  • Family Medicine Physician
  • Elmhurst, NY
  • NPI 1063572212
  NPD (past)

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

{
    "created_epoch": "1167782400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1851448088",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2 SKYVIEW DRIVE",
            "city": "ROCKAWAY",
            "state": "NJ",
            "postal_code": "078662320",
            "telephone_number": "973-664-0387",
            "fax_number": "718-424-2413"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "90 02 QUEENS BLVD",
            "city": "ELMHURST",
            "state": "NY",
            "postal_code": "11373",
            "telephone_number": "718-558-1720",
            "fax_number": "718-558-1783"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ANGKUSTSIRI",
        "first_name": "KASEM",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-01-03",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207ZP0102X",
            "taxonomy_group": "",
            "desc": "Pathology, Anatomic Pathology & Clinical Pathology",
            "state": "NY",
            "license": "122132",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Nashauna Anderson
• Phillip Joseph Anderson, PA
• Inna Andreva-Miller, SOCIAL WORKER
• Johana F Angarita, M.D
• Jeffrey June Angeles, BSN, RN
• Anibal Romero, D.D.S.,P.C.
• Anna C. Tello LCSW PC (Family Counseling Group of Ny)
• Emily Rose Anodide, PA-C
• Carlota Gabriel Antonio, NP
• Anupama Cheruku MD PLLC

• Anatomic Pathology & Clinical Pathology Physician in Elmhurst, NY
• Providers in Elmhurst, NY by specialty
• Anatomic Pathology & Clinical Pathology Physician in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.