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QUEENS BOULEVARD ASC LLC
NPI 1558612762
Clinic/Center - Ambulatory Surgical in Rego Park, NY

Active since September 27, 2012CLIA 33D2053791 · Waiver
9525 QUEENS BLVD, REGO PARK, NY 11374(718) 406-8000(929) 214-4425 Get Directions Write a Review

NPPES record last updated: January 12, 2022. Verified against the NPPES registry weekly; last sync: September 06, 2026.

About Queens Boulevard Asc Llc NPPES

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

QUEENS BOULEVARD ASC LLC (NPI 1558612762) is a healthcare organization registered as an ambulatory surgical in Rego Park, New York and active in the NPI registry since September 2012. The organization holds a CLIA Waiver certificate valid through March 26, 2027 and lists Azeem Khan, Owner, as its authorized official.

NPPES Registry Identity

NPI1558612762
Entity TypeOrganization
Primary Taxonomy261QA1903X
Legal Business NameQUEENS BOULEVARD ASC LLC
Location Address9525 QUEENS BLVDRego Park, NY 11374-4510
Mailing Address95-25 Queens BoulevardRego Park, NY 11374-0000 · (718) 406-8000 · Fax (929) 214-4425
Phone(718) 406-8000
Fax(929) 214-4425
Organization SubpartNo
Authorized OfficialAzeem KhanOwner · (718) 406-8000
Enumeration DateSeptember 27, 2012
Last NPPES UpdateJanuary 12, 2022
NPPES CertifiedJanuary 12, 2022
✔ NPI 1558612762 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyClinic/Center · Ambulatory SurgicalAmbulatory Health Care Facilities
Taxonomy Code261QA1903X
9525 QUEENS BLVD, Rego Park, NY 11374
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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 33D2053791

Queens Blvd ASC LLC · Rego Park, NY
Active · expires Mar 26, 2027
CLIA Number33D2053791
Laboratory TypeAmbulatory Surgery Center
Certificate Effective DateFebruary 7, 2013
Certificate Expiration DateMarch 26, 2027
Laboratory DirectorDr. Azeem Khan
Laboratory Phone(718) 406-8000
Laboratory LocationQueens Blvd ASC LLC95-25 Queens Blvd - 3rd Floor, Rego Park, NY 11374
CLIA data matches this NPI record on: Address Phone
This certificate is issued to a laboratory to perform only waived tests.

Areas of Expertise CMS Part B claims 4

Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.

Biopsy of esophagus, stomach, and/or upper small bowel using a flexible endoscope 43239
This procedure involves using a thin, flexible tube with a light and camera, known as an endoscope, to examine the esophagus, stomach, and upper part of the small intestine. Small tissue samples are taken for further examination to help diagnose various conditions.
123 services120 patients
Biopsy of large bowel using a flexible endoscope 45380
A biopsy of the large bowel using a flexible endoscope is a procedure where a thin, flexible tube with a camera is inserted through the rectum to examine the bowel. If abnormal tissue is found, a small sample is taken for further examination. This helps in diagnosing conditions like inflammation, polyps, or cancer.
104 services103 patients
Removal of polyps or growths of large bowel using an endoscope with mechanical snare 45385
This procedure involves using a thin, flexible tube called an endoscope to examine the large bowel. If any abnormal growths or polyps are found, a tool called a mechanical snare is used to remove them. This is a common method to prevent potential health issues.
36 services36 patients
Colorectal cancer screening; colonoscopy on individual not meeting criteria for high risk G0121
Colorectal cancer screening, such as a colonoscopy, is a preventive measure to detect early signs of cancer in the large intestine. For individuals not at high risk, it's typically recommended at age 50. A small, flexible tube with a camera is used to examine your colon. It's a safe, effective way to catch issues early.
22 services22 patients

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.

JESSICA NEDELKA FNP
Nurse Practitioner (Family)
9525 QUEENS BLVD
REGO PARK, NY 11374
Queens County (516) 734-8500
GURDEEP SAREEN PHARM.D.
Pharmacist
9525 QUEENS BLVD
REGO PARK, NY 11374
Queens County (718) 896-6500
CITY RX INC.
Pharmacy (Community/Retail Pharmacy)
9525 QUEENS BLVD
REGO PARK, NY 11374
Queens County (718) 459-4880
JESSICA M FOLEK MD
Surgery
9525 QUEENS BLVD
REGO PARK, NY 11374
Queens County (718) 575-9595
NEW YORK STATE CATHOLIC HEALTH PLAN, INC.
Health Maintenance Organization
9525 QUEENS BLVD, 8TH FL
REGO PARK, NY 11374
Queens County (718) 896-6500
DMITRIY RUBENOV PHARM.D
Pharmacist
9525 QUEENS BLVD
REGO PARK, NY 11374
Queens County (718) 896-6500
SAINT VINCENT CATHOLIC MEDICAL CENTER
Home Health
9525 QUEENS BLVD
REGO PARK, NY 11374
Queens County (718) 459-4558
DR. SANDHYA JHAVERI M.D.
Pediatrics
9525 QUEENS BLVD, SUITE 520
REGO PARK, NY 11374
Queens County (718) 896-4399

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 Queens Boulevard ASC LLC's NPI number?

The NPI number for Queens Boulevard ASC LLC is 1558612762. It was assigned to this organization in the NPPES registry on September 27, 2012.

Where is Queens Boulevard ASC LLC located?

Queens Boulevard ASC LLC is located at 9525 Queens Blvd, Rego Park, NY 11374. The listed phone number is (718) 406-8000.

What is Queens Boulevard ASC LLC's specialty?

The primary specialty registered for this NPI is Clinic/Center, specializing in Ambulatory Surgical, with taxonomy code 261QA1903X.

Does Queens Boulevard ASC LLC hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 33D2053791) 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 Queens Boulevard ASC LLC was last updated on January 12, 2022. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 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.