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PARK AVENUE AMBULATORY MEDICAL PC
NPI 1609265016
Clinic/Center - Ambulatory Surgical in New York, NY

Active since January 22, 2015CLIA 33D2158386 · Waiver
1045 PARK AVE, NEW YORK, NY 10028(973) 419-0200(973) 419-0244 Get Directions Write a Review

NPPES record last updated: October 15, 2015. Verified against the NPPES registry weekly; last sync: August 09, 2026.

About Park Avenue Ambulatory Medical Pc NPPES

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

PARK AVENUE AMBULATORY MEDICAL PC (NPI 1609265016) is a healthcare organization registered as an ambulatory surgical in New York, New York and active in the NPI registry since January 2015. The organization holds a CLIA Waiver certificate valid through November 27, 2026 and lists Kaixuan Liu, President, as its authorized official.

NPPES Registry Identity

NPI1609265016
Entity TypeOrganization
Primary Taxonomy261QA1903X
Legal Business NamePARK AVENUE AMBULATORY MEDICAL PC
Location Address1045 PARK AVENew York, NY 10028-1030
Mailing Address1045 Park AveNew York, NY 10028-1030
Phone(973) 419-0200
Fax(973) 419-0244
Organization SubpartYesParent: Atlantic Spine Center Llc
Authorized OfficialKaixuan LiuPresident · (973) 419-0200
Enumeration DateJanuary 22, 2015
Last NPPES UpdateOctober 15, 2015
✔ NPI 1609265016 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyClinic/Center · Ambulatory SurgicalAmbulatory Health Care Facilities
Taxonomy Code261QA1903X
License✔ Licensed in NY · 2205381
1045 PARK AVE, New York, NY 10028
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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 33D2158386

Park Avenue Ambulatory Medical PC · New York, NY
Active · expires Nov 27, 2026
CLIA Number33D2158386
Laboratory TypePhysician Office
Certificate Effective DateNovember 28, 2024
Certificate Expiration DateNovember 27, 2026
Laboratory DirectorDr. Kaixuan Liu
Laboratory Phone(212) 430-3600
Laboratory LocationPark Avenue Ambulatory Medical PC1045 Park Avenue, New York, NY 10045
CLIA data matches this NPI record on: Address Name
This certificate is issued to a laboratory to perform only waived tests.

Other Providers at the Same Location NPPES 3

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

DAVID FOX, MD, PC
Surgery (Vascular Surgery)
1045 PARK AVE
NEW YORK, NY 10028
New York County (212) 362-3470
DR. GEORGE E GROSS MD
Psychoanalyst
1045 PARK AVE
NEW YORK, NY 10028
New York County (212) 289-3715
BARBARA EDELSTEIN M.D.
Specialist
1045 PARK AVE
NEW YORK, NY 10028
New York County (212) 860-7700

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 Park Avenue Ambulatory Medical PC's NPI number?

The NPI number for Park Avenue Ambulatory Medical PC is 1609265016. It was assigned to this organization in the NPPES registry on January 22, 2015.

Where is Park Avenue Ambulatory Medical PC located?

Park Avenue Ambulatory Medical PC is located at 1045 Park Ave, New York, NY 10028. The listed phone number is (973) 419-0200.

What is Park Avenue Ambulatory Medical PC's specialty?

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

Does Park Avenue Ambulatory Medical PC hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 33D2158386) is associated with this NPI, valid through November 27, 2026. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

When was this NPI record last updated?

The NPPES record for Park Avenue Ambulatory Medical PC was last updated on October 15, 2015. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 10 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.