Organization Active NPI

Prisma Health Inc

  • Community/Retail Pharmacy
  • Flushing, NY
National Provider Identifier
1972299758
Registry record updated Apr 13, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Retail PharmacyTaxonomy code 3336C0003X
Legal business name
PRISMA HEALTH INC
Practice address
13621 Roosevelt Ave Ste 208
Flushing, NY 11354-5556
Phone
(718) 679-9860
Fax
(718) 799-0401
NPI assigned
Apr 13, 2023
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 13, 2023

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

Authorized official

Name
Xiao ZhangNPI 1730656026
Title
Supervising Pharmacist
Phone
(718) 679-9860

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Retail Pharmacy 3336C0003X Primary

Addresses

Primary practice location

13621 Roosevelt Ave Ste 208
Flushing, NY 11354-5556

Mailing address

13621 Roosevelt Ave Ste 208
Flushing, NY 11354-5556

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20231110000048 NY DME Supplier - Pharmacy 0749637882 Practice locations: Flushing, NY
O20231115000183 NY Part B Supplier - Pharmacy 0749637882 Practice locations: Flushing, NY

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.

Medicare medical equipment & supply locations

SupplierSuppliesMedicare assignment
Prisma Health Inc13621 Roosevelt Ave, Flushing, NY 11354-5556(718) 679-9860 Immunosuppressive Drugs Accepts assignmentParticipating since Sep 27, 2023

National Provider Directory

National Provider Directory

Locations

13621 Roosevelt Ave
Ste 208
Flushing, NY 11354
Phone (718) 679-9860

Practitioners & affiliated clinicians

Practitioners 1

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

NPI Registry JSON

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

{
    "created_epoch": "1681344000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1681344000000",
    "number": "1972299758",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13621 ROOSEVELT AVE STE 208",
            "city": "FLUSHING",
            "state": "NY",
            "postal_code": "113545556"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13621 ROOSEVELT AVE STE 208",
            "city": "FLUSHING",
            "state": "NY",
            "postal_code": "113545556",
            "telephone_number": "718-679-9860",
            "fax_number": "718-799-0401"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PRISMA HEALTH INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-04-13",
        "last_updated": "2023-04-13",
        "certification_date": "2023-04-13",
        "status": "A",
        "authorized_official_last_name": "ZHANG",
        "authorized_official_first_name": "XIAO",
        "authorized_official_title_or_position": "SUPERVISING PHARMACIST",
        "authorized_official_telephone_number": "718-679-9860"
    },
    "taxonomies": [
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Flushing, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 13, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • 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.