JAMAICA QUEENS PROFESSIONAL MEDICAL SERVICES OF NEW YORK LLC
NPI 1578080966
Surgery - Vascular Surgery in Jamaica, NY
NPI Status: Active since August 25, 2017
Contact Information
16203 JAMAICA AVE UNIT 200A
JAMAICA, NY
ZIP 11432
Phone: (718) 301-1100
Fax: (224) 246-8042
- Organization
- Surgery
- Vascular Surgery
- CLIA Number: 33D2157731
- CLIA Cert. Type: Physician Office
- CLIA Exp. Date: 06-04-2027
About JAMAICA QUEENS PROFESSIONAL MEDICAL SERVICES OF NEW YORK LLC
This page provides the complete NPI Profile along with additional information for Jamaica Queens Professional Medical Services Of New York Llc, a provider established in Jamaica, New York operating as a Surgery, focusing in vascular surgery . The healthcare provider is registered in the NPI registry with number 1578080966 assigned on August 2017. The practitioner's primary taxonomy code is 2086S0129X with license number 036105104 (IL). The provider is registered as an organization and their NPI record was last updated 8 years ago. Jamaica Queens Professional Medical Services Of New York Llc operates as a Multi-Specialty Group with one or more individual practitioners, who practice different areas of specialization. The authorized official of this NPI record is Yan Katsnelson Md (Ceo)
- NPI
- 1578080966
- Provider Name
- JAMAICA QUEENS PROFESSIONAL MEDICAL SERVICES OF NEW YORK LLC
- Entity Type
- Organization
- Location Address
- 16203 JAMAICA AVE UNIT 200A JAMAICA, NY 11432
- Location Phone
- (718) 301-1100
- Location Fax
- (224) 246-8042
- Mailing Address
- 304 WAINWRIGHT DR NORTHBROOK, IL 60062
- Mailing Phone
- (847) 257-1244
- Mailing Fax
- (224) 246-8042
- Is Sole Proprietor?
- No
- Is Organization Subpart?
- No
- Enumeration Date
- 08-25-2017
- Last Update Date
- 06-11-2018
- Code Navigator
Location Map
Specialty - Primary Taxonomy
The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.
- Classification
Surgery Vascular Surgery
- Taxonomy Code
- 2086S0129X
- Type
- Allopathic & Osteopathic Physicians
- License No.
- 036105104
- License State
- IL
- Taxonomy Description
- A surgeon with expertise in the management of surgical disorders of the blood vessels, excluding the intracranial vessels or the heart.
Group Taxonomy 193200000X MULTI-SPECIALTY GROUP
This provider is a business group of one or more individual practitioners, who practice with different areas of specialization.
CLIA Information
The Clinical Laboratory Improvement Amendments (CLIA) of 1988 applies to facilities or sites that test human specimens for health assessment or to diagnose, prevent, or treat disease. The CLIA Program sets standards for clinical laboratory testing and issues certificates. The NPI / CLIA crosswalk information for this NPI number is:
- CLIA Number
- 33D2157731
- Facility Type
- Physician Office
- Certificate Effective Date
- June 05, 2025
- Certificate Expiration Date
- June 04, 2027
- Laboratory Director
- MS. AARON M. REICHMAN
- Certificate Type
- Certificate of Compliance
- Certificate Type Description
- This CLIA certificate is issued to Jamaica Queens Professional Medical Services Of New York Llc after an inspection that finds the laboratory to be in compliance with all applicable CLIA requirements. This type of certificate is issued to laboratories that perform nonwaived (moderate and/or high complexity) testing.
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NPI NPI Number Validation
How NPI Validation Works
The NPI validation process uses the ISO-standard Luhn algorithm, a mathematical "handshake", to ensure that a provider's 10-digit ID is authentic and free of common typing errors.
To verify the NPI 1578080966, we treat the final digit (6) as the Check Digit—the target answer we need to reach. The process begins by taking the first nine digits and adding a constant value of 24, which accounts for the "80840" prefix required for all U.S. health identifiers. We then double every other digit starting from the right and sum the individual digits of those results together. For this specific NPI, that total comes to 64. The final step is to find the difference between that total and the next multiple of ten (70 - 64 = 6).
Digit-by-digit view
Use the first nine digits for the calculation. Starting from the right, double every other digit. The last digit is the check digit and is not part of the calculation.
Step 1: Double every other digit from the right
Starting with the rightmost digit of the first nine digits, double every other value. If doubling creates a two-digit number, add those digits together.
Step 2: Add all digits plus the NPI constant
Add the transformed values, the unchanged digits, and the constant 24.
Step 3: Find the amount needed to reach the next multiple of 10
The next multiple of ten after 64 is 70. The difference is the calculated check digit.
Frequently Asked Questions
The NPI number assigned to this healthcare provider is 1578080966, enumerated as an "organization" on August 25, 2017.
The provider is located at 16203 JAMAICA AVE UNIT 200A JAMAICA, NY 11432 and the phone number is (718) 301-1100.
Surgery with taxonomy code 2086S0129X and a focus in Vascular Surgery.
