9317 Medical Office PC

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

Legal business name

9317 MEDICAL OFFICE PC

Practice address

9317 Roosevelt Ave
Jackson Heights, NY 11372-7943

Phone

(718) 446-0270

Fax

(718) 446-5939

NPI assigned

May 10, 2007

Organization subpart

No

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

Authorized official

Name

Sandra J Marrero

Title

Office Manager

Phone

(718) 446-0270

Specialties & licenses 2

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in NY, FL2 enrollments

Enrollment records 2

Interoperability endpoints

• FHIR API: https://fhir4.healow.com/fhir/r4/JJCIAA

Practitioners 3

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

• Annette Perea, M.D.

  • Pediatrics Physician
  • Elmhurst, NY
  • NPI 1811913452

  FL

  Medicare reassignment NPD
• Alain A Sosa, M.D.

  • Internal Medicine Physician
  • Elmhurst, NY
  • NPI 1770503393

  FL

  Medicare reassignment NPD
• Alfredo Antonio Pardo, APRN

  • Family Nurse Practitioner
  • Miami, FL
  • NPI 1043911191
  Medicare reassignment NPD

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

{
    "created_epoch": "1178755200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1718928000000",
    "number": "1871707372",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9317 ROOSEVELT AVE",
            "city": "JACKSON HEIGHTS",
            "state": "NY",
            "postal_code": "113727943",
            "telephone_number": "718-446-0270",
            "fax_number": "718-446-5939"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9317 ROOSEVELT AVE",
            "city": "JACKSON HEIGHTS",
            "state": "NY",
            "postal_code": "113727943",
            "telephone_number": "718-446-0270",
            "fax_number": "718-446-5939"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2645 SW 37th Ave Ste 701",
            "address_purpose": "LOCATION",
            "city": "Miami",
            "state": "FL",
            "postal_code": "331332745",
            "country_code": "US",
            "telephone_number": "718-489-9527",
            "fax_number": "718-446-5939",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "9317 MEDICAL OFFICE PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-10",
        "last_updated": "2024-06-21",
        "certification_date": "2024-06-21",
        "status": "A",
        "authorized_official_last_name": "MARRERO",
        "authorized_official_first_name": "SANDRA",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "718-446-0270"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "208000000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Pediatrics",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01748636",
            "state": "NY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "121841700",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Richard Allen Aaron, DDS
• Wendell Jamias Abad
• Igor Abayev, DDS
• Marya Abbas, LMSW

• Internal Medicine Physician in Jackson Heights, NY
• Providers in Jackson Heights, NY by specialty
• Internal Medicine Physician in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 21, 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.