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BROADWAY INTERNAL MEDICINE P.C
NPI 1124265848
Clinic/Center - Community Health in Elmhurts, NY

Active since January 16, 2009CLIA 33D2065419 · Waiver
7517 41ST AVENUE, ELMHURTS, NY 11373(718) 803-6300(718) 803-0085 Get Directions Write a Review

NPPES record last updated: January 16, 2009. Verified against the NPPES registry weekly; last sync: August 09, 2026.

About Broadway Internal Medicine P.c NPPES

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

BROADWAY INTERNAL MEDICINE P.C (NPI 1124265848) is a healthcare organization registered as a community health in Elmhurts, New York and active in the NPI registry since January 2009. The organization holds a CLIA Waiver certificate valid through September 8, 2027 and lists Carlos Manuel Gonzalez, Physician, as its authorized official.

NPPES Registry Identity

NPI1124265848
Entity TypeOrganization
Primary Taxonomy261QC1500X
Legal Business NameBROADWAY INTERNAL MEDICINE P.C
Location Address7517 41ST AVENUEElmhurts, NY 11373
Mailing Address7517 41st AveElmhurst, NY 11373-1004 · (718) 803-6300
Phone(718) 803-6300
Fax(718) 803-0085
Organization SubpartNo
Authorized OfficialCarlos Manuel GonzalezPhysician · (718) 803-6300
Enumeration DateJanuary 16, 2009
✔ NPI 1124265848 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyClinic/Center · Community HealthAmbulatory Health Care Facilities
Taxonomy Code261QC1500X
License✔ Licensed in NY · 156591
7517 41ST AVENUE, Elmhurts, NY 11373
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Other Identifiers 1

Medicaid1437162024NY

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 33D2065419

Broadway Internal Medicine PC · Elmhurst, NY
Active · expires Sep 8, 2027
CLIA Number33D2065419
Laboratory TypePhysician Office
Certificate Effective DateSeptember 9, 2025
Certificate Expiration DateSeptember 8, 2027
Laboratory DirectorDr. Carlos M. Gonzalez
Laboratory Phone(718) 803-3201
Laboratory LocationBroadway Internal Medicine PC41-07 76th Street, Elmhurst, NY 11373
CLIA data matches this NPI record on: Name
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 Broadway Internal Medicine P.C's NPI number?

The NPI number for Broadway Internal Medicine P.C is 1124265848. It was assigned to this organization in the NPPES registry on January 16, 2009.

Where is Broadway Internal Medicine P.C located?

Broadway Internal Medicine P.C is located at 7517 41st Avenue, Elmhurts, NY 11373. The listed phone number is (718) 803-6300.

What is Broadway Internal Medicine P.C's specialty?

The primary specialty registered for this NPI is Clinic/Center, specializing in Community Health, with taxonomy code 261QC1500X.

Does Broadway Internal Medicine P.C hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 33D2065419) is associated with this NPI, valid through September 8, 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 Broadway Internal Medicine P.C was last updated on January 16, 2009. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 17 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.