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AMBOY MEDICAL PRACTICE PC
NPI 1104692672
Radiology - Diagnostic Radiology in Staten Island, NY

Active since November 27, 2023CLIA 33D2057992 · Waiver
355 BARD AVE, STATEN ISLAND, NY 10310(718) 818-1234 Get Directions Write a Review

NPPES record last updated: November 27, 2023. Verified against the NPPES registry weekly; last sync: August 09, 2026.

About Amboy Medical Practice Pc NPPES

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

AMBOY MEDICAL PRACTICE PC (NPI 1104692672) is a healthcare organization registered as a diagnostic radiology in Staten Island, New York and active in the NPI registry since November 2023. The organization holds a CLIA Waiver certificate valid through March 26, 2027, maintains 4 additional practice locations, and lists Joan Marie Nelson, Director Network Revenue Cycle Oper, as its authorized official.

NPPES Registry Identity

NPI1104692672
Entity TypeOrganization
Primary Taxonomy2085R0202X
Legal Business NameAMBOY MEDICAL PRACTICE PC
Location Address355 BARD AVEStaten Island, NY 10310-1664
Mailing Address360 Bard Ave # LlStaten Island, NY 10310-1666 · (171) 881-8453 · Fax (347) 825-2117
Phone(718) 818-1234
Organization SubpartNo
Authorized OfficialJoan Marie NelsonDirector Network Revenue Cycle Oper · (718) 818-4531
Enumeration DateNovember 27, 2023
NPPES CertifiedNovember 27, 2023
✔ NPI 1104692672 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 8

★ Primary SpecialtyRadiology · Diagnostic RadiologyAllopathic & Osteopathic Physicians
Taxonomy Code2085R0202X
Definition
A radiologist who utilizes x-ray, radionuclides, ultrasound and electromagnetic radiation to diagnose and treat disease.
Also ListedRadiology · Body ImagingTaxonomy 2085B0100X
Also ListedRadiology · Diagnostic NeuroimagingTaxonomy 2085D0003X
Also ListedRadiology · Nuclear RadiologyTaxonomy 2085N0904X
Also ListedRadiology · Pediatric RadiologyTaxonomy 2085P0229X
Also ListedRadiology · Radiation OncologyTaxonomy 2085R0001X
Also ListedRadiology · Vascular & Interventional RadiologyTaxonomy 2085R0204X
Also ListedRadiology · Diagnostic UltrasoundTaxonomy 2085U0001X
355 BARD AVE, Staten Island, NY 10310
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Secondary Practice Locations 4

Location 11058 Forest AveStaten Island, NY 10310-2419 · Phone (718) 818-1058 · Fax (855) 449-6480
Location 24360 Hylan BlvdStaten Island, NY 10312-6522 · Phone (718) 818-4360 · Fax (718) 317-9134
Location 31161 Victory BlvdStaten Island, NY 10301-3621 · Phone (718) 818-1161 · Fax (855) 451-7988
Location 41000 South AveStaten Island, NY 10314-3409 · Phone (718) 816-4949 · Fax (718) 370-8731

Group Practice 1

Group TaxonomyThis provider is a business group of one or more individual practitioners, who practice with different areas of specialization.193200000X MULTI-SPECIALTY GROUP

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 33D2057992

Amboy Medical Practice PC · Staten Island, NY
Active · expires Mar 26, 2027
CLIA Number33D2057992
Laboratory TypeAncillary Testing Site In Health Care Center
Certificate Effective DateApril 26, 2013
Certificate Expiration DateMarch 26, 2027
Laboratory DirectorDr. Alexander Beylinson
Laboratory Phone(718) 984-9658
Laboratory LocationAmboy Medical Practice PC4434 Amboy Road, Staten Island, NY 10312
CLIA data matches this NPI record on: Name
This certificate is issued to a laboratory to perform only waived tests.

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

MRS. DONNA MARIE LUTZ MSCCC-A
Audiologist-Hearing Aid Fitter
355 BARD AVE
STATEN ISLAND, NY 10310
Richmond County (718) 818-2250
ALL ISLAND PHYSICIAN PRACTICE PC
Internal Medicine (Endocrinology, Diabetes & Metabolism)
355 BARD AVE
STATEN ISLAND, NY 10310
Richmond County (718) 818-3327
SAINT VINCENT CATHOLIC MEDICAL CENTER
Psychiatric Unit
355 BARD AVE
STATEN ISLAND, NY 10310
Richmond County (718) 818-1234
LISA MAHER PA
Physician Assistant
355 BARD AVE, RICHMOND UNIVERSITY MEDICAL CENTER
STATEN ISLAND, NY 10310
Richmond County (718) 818-1117
MRS. ANNA MENZA FNP
Nurse Practitioner (Family)
355 BARD AVE
STATEN ISLAND, NY 10310
Richmond County (718) 818-1234
CAROLINE MEURER DA CUNHA
Student in an Organized Health Care Education/Training Program
355 BARD AVE
STATEN ISLAND, NY 10310
Richmond County (718) 818-1234
ALLEN CHO
Student in an Organized Health Care Education/Training Program
355 BARD AVE
STATEN ISLAND, NY 10310
Richmond County (718) 818-2419
EDWARD ADRIAN M.D.
Emergency Medicine
355 BARD AVE, EMERGENCY DEPT
STATEN ISLAND, NY 10310
Richmond County (718) 818-2055

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 Amboy Medical Practice PC's NPI number?

The NPI number for Amboy Medical Practice PC is 1104692672. It was assigned to this organization in the NPPES registry on November 27, 2023.

Where is Amboy Medical Practice PC located?

Amboy Medical Practice PC is located at 355 Bard Ave, Staten Island, NY 10310. The listed phone number is (718) 818-1234.

What is Amboy Medical Practice PC's specialty?

The primary specialty registered for this NPI is Radiology, specializing in Diagnostic Radiology, with taxonomy code 2085R0202X.

Does Amboy Medical Practice PC hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 33D2057992) is associated with this NPI, valid through March 26, 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 Amboy Medical Practice PC was last updated on November 27, 2023. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 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.