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WOODSIDE MEDICAL CARE
NPI 1003287343
Clinic/Center - Primary Care in Woodside, NY

Active since October 13, 2015CLIA 33D1014172 · Waiver
6019 ROOSEVELT AVE STE 201, WOODSIDE, NY 11377(718) 446-6579(718) 446-1213 Get Directions Write a Review

NPPES record last updated: December 27, 2018. Verified against the NPPES registry weekly; last sync: August 09, 2026.

About Woodside Medical Care NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

WOODSIDE MEDICAL CARE (NPI 1003287343) is a healthcare organization registered as a primary care in Woodside, New York and active in the NPI registry since October 2015. The organization holds a CLIA Waiver certificate valid through January 1, 2027, maintains a secondary practice location in Woodside, and lists Daniel Park, President, as its authorized official.

NPPES Registry Identity

NPI1003287343
Entity TypeOrganization
Primary Taxonomy261QP2300X
Legal Business NameWOODSIDE MEDICAL CARE
Location Address6019 ROOSEVELT AVE STE 201Woodside, NY 11377-3537
Mailing Address6019 Roosevelt Ave Ste 201Woodside, NY 11377-3537 · (718) 446-6579 · Fax (718) 446-1213
Phone(718) 446-6579
Fax(718) 446-1213
Organization SubpartNo
Authorized OfficialDaniel ParkPresident · (718) 446-6579
Enumeration DateOctober 13, 2015
Last NPPES UpdateDecember 27, 2018
✔ NPI 1003287343 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyClinic/Center · Primary CareAmbulatory Health Care Facilities
Taxonomy Code261QP2300X
License✔ Licensed in NY · 209387
6019 ROOSEVELT AVE STE 201, Woodside, NY 11377
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Secondary Practice Location 1

Location 16014 Roosevelt Ave Ste 7Woodside, NY 11377-3538 · Phone (718) 446-6570

CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Waiver 33D1014172

Woodside Medical Care · Woodside, NY
Active · expires Jan 1, 2027
CLIA Number33D1014172
Laboratory TypePhysician Office
Certificate Effective DateJanuary 2, 2025
Certificate Expiration DateJanuary 1, 2027
Laboratory DirectorDr. Daniel D. Park
Laboratory Phone(718) 446-6579
Laboratory LocationWoodside Medical Care60-19 Roosevelt Ave, #201, Woodside, NY 11377
CLIA data matches this NPI record on: Name Phone
This certificate is issued to a laboratory to perform only waived tests.

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Woodside Medical Care's NPI number?

The NPI number for Woodside Medical Care is 1003287343. It was assigned to this organization in the NPPES registry on October 13, 2015.

Where is Woodside Medical Care located?

Woodside Medical Care is located at 6019 Roosevelt Ave Ste 201, Woodside, NY 11377. The listed phone number is (718) 446-6579.

What is Woodside Medical Care's specialty?

The primary specialty registered for this NPI is Clinic/Center, specializing in Primary Care, with taxonomy code 261QP2300X.

Does Woodside Medical Care hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 33D1014172) is associated with this NPI, valid through January 1, 2027. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

When was this NPI record last updated?

The NPPES record for Woodside Medical Care was last updated on December 27, 2018. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 7 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.