Organization Active NPI

Freedom Care Ipa, Ooc

  • Clinical Informatics Physician
  • New Hyde Park, NY
National Provider Identifier
1972137537
Registry record updated Feb 23, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Informatics PhysicianTaxonomy code 2083C0008X
Legal business name
FREEDOM CARE IPA, OOC
Practice address
1979 Marcus Ave Ste C115
New Hyde Park, NY 11042-1126
Phone
(718) 989-9710
NPI assigned
Feb 23, 2020
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 23, 2020

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

Authorized official

Name
Benjamin Wolf
Title
General Counsel
Phone
(718) 989-9710

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Informatics PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 2083C0008X Primary

Addresses

Primary practice location

1979 Marcus Ave Ste C115
New Hyde Park, NY 11042-1126

Mailing address

1979 Marcus Ave Ste C115
New Hyde Park, NY 11042-1126
Phone (718) 989-9710

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1582416000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1582416000000",
    "number": "1972137537",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1979 MARCUS AVE STE C115",
            "city": "NEW HYDE PARK",
            "state": "NY",
            "postal_code": "110421126",
            "telephone_number": "718-989-9710"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1979 MARCUS AVE STE C115",
            "city": "NEW HYDE PARK",
            "state": "NY",
            "postal_code": "110421126",
            "telephone_number": "718-989-9710"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FREEDOM CARE IPA, OOC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-02-23",
        "last_updated": "2020-02-23",
        "certification_date": "2020-02-23",
        "status": "A",
        "authorized_official_last_name": "WOLF",
        "authorized_official_first_name": "BENJAMIN",
        "authorized_official_title_or_position": "GENERAL COUNSEL",
        "authorized_official_telephone_number": "718-989-9710"
    },
    "taxonomies": [
        {
            "code": "2083C0008X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Preventive Medicine, Clinical Informatics",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New Hyde Park, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 23, 2020; 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.