PARK AVENUE MEDICAL OFFICE, PLLC
NPI 1013568435
Internal Medicine - Allergy & Immunology in New York, NY
NPI Status: Active since September 26, 2019
Contact Information
642 PARK AVE
NEW YORK, NY
ZIP 10065
Phone: (212) 517-6611
Fax: (212) 517-2132
- Organization
- Internal Medicine
- Allergy & Immunology
- CLIA Number: 33D2178880
- CLIA Cert. Type: Physician Office
- CLIA Exp. Date: 02-10-2028
About PARK AVENUE MEDICAL OFFICE, PLLC
This page provides the complete NPI Profile along with additional information for Park Avenue Medical Office, Pllc, an internist established in New York, New York operating as a Internal Medicine, focusing in allergy & immunology . The healthcare provider is registered in the NPI registry with number 1013568435 assigned on September 2019. The practitioner's primary taxonomy code is 207RA0201X. The provider is registered as an organization and their NPI record was last updated 7 years ago. The organization operates as a Single Specialty Group with one or more individual practitioners, all of who practice with the same area of specialization. The authorized official of this NPI record is Dr. Wellington S Tichenor Md (Owner)
- NPI
- 1013568435
- Provider Name
- PARK AVENUE MEDICAL OFFICE, PLLC
- Entity Type
- Organization
- Location Address
- 642 PARK AVE NEW YORK, NY 10065
- Location Phone
- (212) 517-6611
- Location Fax
- (212) 517-2132
- Mailing Address
- 642 PARK AVE NEW YORK, NY 10065
- Mailing Phone
- (212) 517-6611
- Mailing Fax
- (212) 517-2132
- Is Sole Proprietor?
- No
- Is Organization Subpart?
- No
- Enumeration Date
- 09-26-2019
- Last Update Date
- 09-26-2019
- Code Navigator
An internist like Park Avenue Medical Office, Pllc is a physician who has completed an internal medicine residency and is board-certified or board-eligible in an internist specialty. Internists are trained to care for adults of all ages for many different medical conditions. An internist typically monitors chronic physical conditions, identifies acute diseases, provides family planning, provides counseling about wellness and disease prevention, etc.
Location Map
Specialty - Primary Taxonomy
The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.
- Classification
Internal Medicine Allergy & Immunology
- Taxonomy Code
- 207RA0201X
- Type
- Allopathic & Osteopathic Physicians
- Taxonomy Description
- An internist doctor of osteopathy that specializes in the treatment of allergy and immunologic disorders. A doctor of osteopathy that is board eligible/certified by the American Osteopathic Board of Internal Medicine can obtain a Certificate of Special Qualifications in the field of Allergy & Immunology.
Group Taxonomy 193400000X SINGLE SPECIALTY GROUP
This provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.
CLIA Information
The Clinical Laboratory Improvement Amendments (CLIA) of 1988 applies to facilities or sites that test human specimens for health assessment or to diagnose, prevent, or treat disease. The CLIA Program sets standards for clinical laboratory testing and issues certificates. The NPI / CLIA crosswalk information for this NPI number is:
- CLIA Number
- 33D2178880
- Facility Type
- Physician Office
- Certificate Effective Date
- February 11, 2026
- Certificate Expiration Date
- February 10, 2028
- Laboratory Director
- DR. WELLINGTON TICHENOR
- Certificate Type
- Certificate for Provider-Performed Microscopy Procedures (PPMP)
- Certificate Type Description
- This CLIA certificate is issued to Park Avenue Medical Office, Pllc in which a physician, midlevel practitioner or dentist that performs specific microscopy procedures during the course of a patient's visit. A limited list of provider-performed microscopy procedures is included under this certificate type, which are categorized as moderate complexity testing.
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NPI NPI Number Validation
How NPI Validation Works
The NPI validation process uses the ISO-standard Luhn algorithm, a mathematical "handshake", to ensure that a provider's 10-digit ID is authentic and free of common typing errors.
To verify the NPI 1013568435, we treat the final digit (5) as the Check Digit—the target answer we need to reach. The process begins by taking the first nine digits and adding a constant value of 24, which accounts for the "80840" prefix required for all U.S. health identifiers. We then double every other digit starting from the right and sum the individual digits of those results together. For this specific NPI, that total comes to 55. The final step is to find the difference between that total and the next multiple of ten (60 - 55 = 5).
Digit-by-digit view
Use the first nine digits for the calculation. Starting from the right, double every other digit. The last digit is the check digit and is not part of the calculation.
Step 1: Double every other digit from the right
Starting with the rightmost digit of the first nine digits, double every other value. If doubling creates a two-digit number, add those digits together.
Step 2: Add all digits plus the NPI constant
Add the transformed values, the unchanged digits, and the constant 24.
Step 3: Find the amount needed to reach the next multiple of 10
The next multiple of ten after 55 is 60. The difference is the calculated check digit.
Other Providers at the Same Location
The following 1 provider is registered at the same or a nearby location.
Frequently Asked Questions
The NPI number assigned to this healthcare provider is 1013568435, enumerated as an "organization" on September 26, 2019.
The provider is located at 642 PARK AVE NEW YORK, NY 10065 and the phone number is (212) 517-6611.
Internal Medicine with taxonomy code 207RA0201X and a focus in Allergy & Immunology.
