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KAMYAR DAVID TAVAKOLI PHYSICIAN PLLC
NPI 1396991774
Internal Medicine in Hollis, NY

Active since August 17, 2008CLIA 33D0883828 · Waiver
19115 HILLSIDE AVE, HOLLIS, NY 11423(718) 217-5200 Get Directions Write a Review

NPPES record last updated: August 17, 2008. Verified against the NPPES registry weekly; last sync: August 16, 2026.

About Kamyar David Tavakoli Physician Pllc NPPES

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

KAMYAR DAVID TAVAKOLI PHYSICIAN PLLC (NPI 1396991774) is a healthcare organization registered as an internal medicine in Hollis, New York and active in the NPI registry since August 2008. The organization holds a CLIA Waiver certificate valid through March 17, 2028 and lists Daniel Tavakoli, Bookkeeper, as its authorized official.

NPPES Registry Identity

NPI1396991774
Entity TypeOrganization
Primary Taxonomy207R00000X
Legal Business NameKAMYAR DAVID TAVAKOLI PHYSICIAN PLLC
Location Address19115 HILLSIDE AVEHollis, NY 11423-1941
Mailing Address19115 Hillside AveHollis, NY 11423-1941
Phone(718) 217-5200
Organization SubpartNo
Authorized OfficialDaniel TavakoliBookkeeper · (718) 217-5200
Enumeration DateAugust 17, 2008
✔ NPI 1396991774 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyInternal MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207R00000X
License✔ Licensed in NY · 190615
Definition
A physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults and the elderly. Internists are trained in the diagnosis and treatment of cancer, infections and diseases affecting the heart, blood, kidneys, joints and digestive, respiratory and vascular systems. They are also trained in the essentials of primary care internal medicine, which incorporates an understanding of disease prevention, wellness, substance abuse, mental health and effective treatment of common problems of the eyes, ears, skin, nervous system and reproductive organs.
19115 HILLSIDE AVE, Hollis, NY 11423
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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 33D0883828

Kamyar David Tavakoli, MD · Queens Village, NY
Active · expires Mar 17, 2028
CLIA Number33D0883828
Laboratory TypePhysician Office
Certificate Effective DateMarch 18, 2026
Certificate Expiration DateMarch 17, 2028
Laboratory DirectorKamyar D. Tavakoli
Laboratory Phone(718) 217-5200
Laboratory LocationKamyar David Tavakoli, MD214-40 Hillside Ave, Queens Village, NY 11427
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 2

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

DR. KAMYAR D TAVAKOLI M.D,
Internal Medicine
19115 HILLSIDE AVE
HOLLIS, NY 11423
Queens County (718) 217-5200
CAREFIRST MEDICAL PLLC
Internal Medicine
19115 HILLSIDE AVE
HOLLIS, NY 11423
Queens County (516) 858-0204

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 Kamyar David Tavakoli Physician PLLC's NPI number?

The NPI number for Kamyar David Tavakoli Physician PLLC is 1396991774. It was assigned to this organization in the NPPES registry on August 17, 2008.

Where is Kamyar David Tavakoli Physician PLLC located?

Kamyar David Tavakoli Physician PLLC is located at 19115 Hillside Ave, Hollis, NY 11423. The listed phone number is (718) 217-5200.

What is Kamyar David Tavakoli Physician PLLC's specialty?

The primary specialty registered for this NPI is Internal Medicine with taxonomy code 207R00000X.

Does Kamyar David Tavakoli Physician PLLC hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 33D0883828) is associated with this NPI, valid through March 17, 2028. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

When was this NPI record last updated?

The NPPES record for Kamyar David Tavakoli Physician PLLC was last updated on August 17, 2008. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 18 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.