Organization Active NPI

Hillside Pediatrics P.C.

  • Pediatrics Physician
  • Floral Park, NY
National Provider Identifier
1871595769
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
203392 Issued in NY
Legal business name
HILLSIDE PEDIATRICS P.C.
Practice address
25602 Hillside Ave
1St Floor
Floral Park, NY 11004-1618
Phone
(718) 343-3535
Fax
(718) 343-7272
NPI assigned
Aug 11, 2005
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Mayank C Patel, M.D.NPI 1336191220
Title
President
Phone
(718) 343-3535

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
Pediatrics PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 208000000X 203392 NY Primary

Addresses

Primary practice location

25602 Hillside Ave
1St Floor
Floral Park, NY 11004-1618

Mailing address

25602 Hillside Ave
1St Floor
Floral Park, NY 11004-1618
Phone (718) 343-3535

Other identifiers 1

IdentifierTypeStateIssuer
01679845MedicaidNY

National Provider Directory

National Provider Directory

Locations

25602 Hillside Ave
#1
Floral Park, NY 11004
Phone (718) 343-3535

Practitioners & affiliated clinicians

Practitioners 1

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

NPI Registry JSON

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

{
    "created_epoch": "1123718400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1871595769",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "25602 HILLSIDE AVE",
            "address_2": "1ST FLOOR",
            "city": "FLORAL PARK",
            "state": "NY",
            "postal_code": "110041618",
            "telephone_number": "718-343-3535",
            "fax_number": "718-343-7272"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "25602 HILLSIDE AVE",
            "address_2": "1ST FLOOR",
            "city": "FLORAL PARK",
            "state": "NY",
            "postal_code": "110041618",
            "telephone_number": "718-343-3535",
            "fax_number": "718-343-7272"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HILLSIDE PEDIATRICS P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-08-11",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "PATEL",
        "authorized_official_first_name": "MAYANK",
        "authorized_official_middle_name": "C",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "718-343-3535",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Pediatrics",
            "state": "NY",
            "license": "203392",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01679845",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Floral Park, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.