NPIMap

Organization Active NPI

City Medical of Upper East Side, PLLC

  • Clinic/Center
  • Roslyn Heights, NY
National Provider Identifier
1912760034
Registry record updated Mar 5, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinic/CenterTaxonomy code 261Q00000X
Legal business name
CITY MEDICAL OF UPPER EAST SIDE, PLLC
Practice address
363 Willis Ave
Roslyn Heights, NY 11577-2321
Phone
(516) 430-5780
NPI assigned
Feb 1, 2024
Last updated
Mar 5, 2025By the provider in NPPES
Organization subpart
Yes
Parent organization
CITY MEDICAL OF UPPER EAST SIDE, PLLCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Mar 5, 2025

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

Authorized official

Name
Swahili Henry
Title
Director of Payment Solutions
Phone
(908) 988-0428

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinic/Center 261Q00000X NU Primary

Addresses

Primary practice location

363 Willis Ave
Roslyn Heights, NY 11577-2321

Mailing address

1345 Avenue of the Americas FL 8
New York, NY 10105-0018
Phone (908) 588-3635

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
33D2186966City Medical of Upper East Side PLLC363 Willis Ave, Roslyn Heights, NY 11577Certificate of waiverMar 26, 2027

National Provider Directory

National Provider Directory
Tax ID family
City Medical of Upper East Side PLLC136 organizations share this tax ID, including this one
Part of
City Medical of Upper East Side PLLC

Organizations with this tax ID in the same state 24

This tax ID family is large, so up to 24 of its organizations in the same state are linked here.

View all 24

Locations

363 Willis Ave
Roslyn Heights, NY 11577
Phone (516) 430-5780

NPI Registry JSON

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

{
    "created_epoch": "1706745600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1741132800000",
    "number": "1912760034",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1345 AVENUE OF THE AMERICAS FL 8",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "101050018",
            "telephone_number": "908-588-3635"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "363 WILLIS AVE",
            "city": "ROSLYN HEIGHTS",
            "state": "NY",
            "postal_code": "115772321",
            "telephone_number": "516-430-5780"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CITY MEDICAL OF UPPER EAST SIDE, PLLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "CITY MEDICAL OF UPPER EAST SIDE, PLLC",
        "enumeration_date": "2024-02-01",
        "last_updated": "2025-03-05",
        "certification_date": "2025-03-05",
        "status": "A",
        "authorized_official_last_name": "HENRY",
        "authorized_official_first_name": "SWAHILI",
        "authorized_official_title_or_position": "DIRECTOR OF PAYMENT SOLUTIONS",
        "authorized_official_telephone_number": "908-988-0428"
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Roslyn Heights, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 5, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.