Columbus Circle Medical Services PC

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

250331 Issued in NY

Legal business name

COLUMBUS CIRCLE MEDICAL SERVICES PC

Practice address

17121 Jamaica Ave
Jamaica, NY 11432-5427

Phone

(718) 521-4442

Fax

(718) 305-4568

NPI assigned

Jun 5, 2017

Last updated

Jan 29, 2020By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Prabash Koneru, MDNPI 1033306204

Title

Ceo

Phone

(347) 276-8866

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in NY

Enrollment records 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Prabash Koneru, M.D.

  • Internal Medicine Physician
  • Brooklyn, NY
  • NPI 1033306204
  Medicare reassignment Authorized official

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

{
    "created_epoch": "1496620800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1580256000000",
    "number": "1952830937",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2114 PACIFIC BLVD",
            "city": "ATLANTIC BEACH",
            "state": "NY",
            "postal_code": "115091139"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17121 JAMAICA AVE",
            "city": "JAMAICA",
            "state": "NY",
            "postal_code": "114325427",
            "telephone_number": "718-521-4442",
            "fax_number": "718-305-4568"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "721 Flushing Ave",
            "address_purpose": "LOCATION",
            "city": "Brooklyn",
            "state": "NY",
            "postal_code": "11206",
            "country_code": "US",
            "telephone_number": "347-671-7575",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "COLUMBUS CIRCLE MEDICAL SERVICES PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-06-05",
        "last_updated": "2020-01-29",
        "certification_date": "2020-01-29",
        "status": "A",
        "authorized_official_last_name": "KONERU",
        "authorized_official_first_name": "PRABASH",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "347-276-8866",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NY",
            "license": "250331",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Joy Collins
• Leron Collins Jr., D.C
• Wendy Collins
• Jodecy Colon, RN
• Lizza I Colon, SLP, TSHH
• Fabrice Coly
• Donna Commissiong
• Community Healthcare Network Inc (Elephant)
• Community Healthcare Network Inc. (Community Healthcare Network Pharmacy)
• Community Healthcare Network, Inc (Ohio)

• Internal Medicine Physician in Jamaica, NY
• Providers in Jamaica, 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 Jan 29, 2020; 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.