Premier Medical, PLLC

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

158418 Issued in NY

Legal business name

PREMIER MEDICAL, PLLC

Practice address

265 Mason Ave
Staten Island, NY 10305-3412

Phone

(718) 979-5880

Fax

(718) 979-6476

NPI assigned

Nov 7, 2007

Organization subpart

No

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

Authorized official

Name

Dr. Jeffry Tambor, M.D.

Title

Medical Director

Phone

(718) 979-5880

Specialties & licenses 1

Addresses

Other identifiers 1

Practitioners 3

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

• Wissam Hoyek, MD

  • Cardiovascular Disease Physician
  • Staten Island, NY
  • NPI 1629186721
  NPD
• Russell W. Kadro

  • Family Nurse Practitioner
  • Staten Island, NY
  • NPI 1639950033
  NPD
• Maria Regina Scudiero, NURSE PRACTICIONER

  • Family Nurse Practitioner
  • Brooklyn, NY
  • NPI 1043055783
  NPD

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

{
    "created_epoch": "1194393600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1446422400000",
    "number": "1962682864",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 141296",
            "city": "STATEN ISLAND",
            "state": "NY",
            "postal_code": "103141296",
            "telephone_number": "718-979-5880",
            "fax_number": "718-979-6476"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "265 MASON AVE",
            "city": "STATEN ISLAND",
            "state": "NY",
            "postal_code": "103053412",
            "telephone_number": "718-979-5880",
            "fax_number": "718-979-6476"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PREMIER MEDICAL, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-11-07",
        "last_updated": "2015-11-02",
        "status": "A",
        "authorized_official_last_name": "TAMBOR",
        "authorized_official_first_name": "JEFFRY",
        "authorized_official_title_or_position": "MEDICAL DIRECTOR",
        "authorized_official_telephone_number": "718-979-5880",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine",
            "state": "NY",
            "license": "158418",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01925915",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Pre-Care Speech Language Pathology PC.
• Precious Movements Physical Therapy, P.C.
• Precision Health Inc
• Precision Health Inc
• Premier Internal Medicine Associates PC
• Premier Neuromed Services PC
• Premier Pediatrics of New York, PC
• Jennifer Premus
• Michael Anthony Premus, RPH
• Anna Marie Prendergass, RN

• Internal Medicine Physician in Staten Island, NY
• Providers in Staten Island, 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 Nov 2, 2015; 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.