JIB MEDICAL P.C. - NPI 1215334321 - General Practice in Flushing, NY

Q: What is the provider's specialty?

The provider's specialty is General Practice with taxonomy code 208D00000X.

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About Jib Medical P.c. NPPES

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

JIB MEDICAL P.C. (NPI 1215334321) is a healthcare organization registered as a general practice in Flushing, New York and active in the NPI registry since December 2014. The organization holds a CLIA Waiver certificate valid through March 26, 2027 and lists Michael E Makover, Ceo, Cmo, as its authorized official.

NPPES Registry Identity

NPI1215334321

Entity TypeOrganization

Primary Taxonomy208D00000X

Legal Business NameJIB MEDICAL P.C.

Location Address15811 HARRY VAN ARSDALE JR AVE, 2ND FLOORFlushing, NY 11365-3085

Mailing Address15811 Harry Van Arsdale Jr Ave, 2nd FloorFlushing, NY 11365-3085 · (718) 591-2400 · Fax (718) 591-9528

Phone(718) 591-2400

Fax(718) 591-9528

Organization SubpartNo

Authorized OfficialMichael E MakoverCeo, Cmo · (718) 591-2000

Enumeration DateDecember 4, 2014

Last NPPES UpdateFebruary 11, 2015

✔ NPI 1215334321 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyGeneral PracticeAllopathic & Osteopathic Physicians

Taxonomy Code208D00000X

Definition

A physician who specializes in the general practice of diagnosing, treating, and managing patients with a variety of illnesses and conditions. Source: National Uniform Claim Committee

15811 HARRY VAN ARSDALE JR AVE, Flushing, NY 11365

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Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE 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 33D2280945

Jib Medical Pc/Jib Services Inc · Flushing, NY

Active · expires Mar 26, 2027

CLIA Number33D2280945

Laboratory TypePhysician Office

Certificate Effective DateApril 28, 2023

Certificate Expiration DateMarch 26, 2027

Laboratory DirectorDr. Michael E. Makover

Laboratory Phone(718) 591-2000

Laboratory LocationJib Medical Pc/Jib Services Inc158-11 Jewel Ave, Flushing, NY 11365

CLIA data matches this NPI record on: Phone

This certificate is issued to a laboratory to perform only waived tests.

Other Providers at the Same Location NPPES 8

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

DR. ALLEN CHIN OD

Optometrist

15811 HARRY VAN ARSDALE JR AVE, OPTICAL DEPT JOINT INDUSTRY BOARD
FLUSHING, NY 11365

Queens County (718) 591-2014

DR. VERA LETTINI OD

Optometrist