COMPREHENSIVE FAMILY MEDICAL PRACTICE, PC
NPI 1194023135
Family Medicine in Bayside, NY
About Comprehensive Family Medical Practice, Pc NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
COMPREHENSIVE FAMILY MEDICAL PRACTICE, PC (NPI 1194023135) is a healthcare organization registered as a family medicine in Bayside, New York and active in the NPI registry since February 2011. The organization lists Jia Park, Owner, as its authorized official.
NPPES Registry Identity
Specialties & Licenses 3
Group Practice 2
Medicare Participation & PECOS CMS
Medicare enrollment, revalidation and the clinicians who bill Medicare through this organization, from CMS.
Medicare Enrollment Status
Enrolled in Medicare (PECOS)
Comprehensive Family Medical Practice, Pc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Medicare Revalidation Due Date
Revalidation due by November 30, 2026
Medicare-enrolled providers and suppliers confirm their enrollment information with CMS on a set cycle, every 5 years for most and every 3 years for medical equipment suppliers. CMS sets the due date for each enrollment.
Clinicians Billing Medicare Through This Organization
Medicare enrollment records show 1 clinician reassigns Medicare billing to Comprehensive Family Medical Practice, PC, which bills Medicare for the services this clinician delivers.
Clinician (1)
Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
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 Comprehensive Family Medical Practice, PC's NPI number?
The NPI number for Comprehensive Family Medical Practice, PC is 1194023135. It was assigned to this organization in the NPPES registry on February 28, 2011.
Where is Comprehensive Family Medical Practice, PC located?
Comprehensive Family Medical Practice, PC is located at 21008 35th Ave, Bayside, NY 11361. The listed phone number is (718) 229-4090.
What is Comprehensive Family Medical Practice, PC's specialty?
The primary specialty registered for this NPI is Family Medicine with taxonomy code 207Q00000X.
Is Comprehensive Family Medical Practice, PC enrolled in Medicare?
Yes. Comprehensive Family Medical Practice, PC is registered in the Medicare PECOS enrollment system.
When is Comprehensive Family Medical Practice, PC's Medicare revalidation due?
According to the CMS Revalidation Due Date List (October 2026 release), the Medicare Non-DME Part B enrollment for this organization (New York, Clinic/Group Practice) is due for revalidation by November 30, 2026. Medicare providers and suppliers revalidate their enrollment every 5 years, and medical equipment suppliers every 3 years. Confirm current requirements with your Medicare Administrative Contractor.
How many clinicians bill Medicare through Comprehensive Family Medical Practice, PC?
According to the CMS Revalidation Reassignment List (October 2026 release), 1 clinician (Family Practice) reassigns their Medicare billing to Comprehensive Family Medical Practice, PC. A reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for the clinician's services. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
When was this NPI record last updated?
The NPPES record for Comprehensive Family Medical Practice, PC was last updated on March 19, 2021. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 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.
# Comprehensive Family Medical Practice, Pc · NPI 1194023135
Family Medicine organization in Bayside, New York. Organization record, active in the CMS NPPES registry since February 28, 2011.
## Identity
- **NPI:** 1194023135 (Entity type: Organization)
- **Enumerated:** February 28, 2011
- **Primary specialty:** Family Medicine · taxonomy 207Q00000X
- **Organization subpart:** No
- **Authorized official:** Jia Park, OWNER
## Practice location
- **Address:** 21008 35TH AVE, Bayside, NY 11361-1431
- **Phone:** (718) 229-4090 · **Fax:** (866) 457-6793
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Medicare revalidation due:** November 30, 2026 (Non-DME Part B, New York, Clinic/Group Practice) · CMS Revalidation Due Date List, October 2026 release
- **Clinicians billing through this organization:** 1 clinician (Family Practice) reassigns Medicare billing to this organization (form CMS-855R) · CMS Revalidation Reassignment List, October 2026 release
## Record status
- **NPPES last updated:** March 19, 2021
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Source: [NPI Profile](https://npiprofile.com/npi/1194023135) · Data from the CMS NPPES public registry.