Queens Rego Medical PC

Primary specialty

Psychiatry PhysicianTaxonomy code 2084P0800X

Legal business name

QUEENS REGO MEDICAL PC

Practice address

9520 63Rd Rd Ste H
Rego Park, NY 11374-1145

Phone

(646) 301-2578

Fax

(866) 310-5525

NPI assigned

Nov 1, 2017

Last updated

Nov 1, 2017By 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

Edward Shalts, MDNPI 1518035732

Title

Medical Director

Phone

(646) 301-2578

Specialties & licenses 1

Addresses

Other identifiers 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.

• Edward Shalts, MD

  • Psychiatry Physician
  • Rego Park, NY
  • NPI 1518035732
  Authorized official Same address or phone

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

{
    "created_epoch": "1509494400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1509494400000",
    "number": "1962914721",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 520390",
            "city": "FLUSHING",
            "state": "NY",
            "postal_code": "11355",
            "telephone_number": "347-730-4606",
            "fax_number": "866-310-5525"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9520 63RD RD STE H",
            "city": "REGO PARK",
            "state": "NY",
            "postal_code": "113741145",
            "telephone_number": "646-301-2578",
            "fax_number": "866-310-5525"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "QUEENS REGO MEDICAL PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-11-01",
        "last_updated": "2017-11-01",
        "status": "A",
        "authorized_official_last_name": "SHALTS",
        "authorized_official_first_name": "EDWARD",
        "authorized_official_title_or_position": "MEDICAL DIRECTOR",
        "authorized_official_telephone_number": "646-301-2578",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01807432",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Psychiatry Physician in Rego Park, NY
• Providers in Rego Park, NY by specialty
• Psychiatry Physician in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 1, 2017; 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.