CITYMD URGENT CARE (CITY MEDICAL OF UPPER EAST SIDE, PLLC) NPI 1619465721

Clinic/Center (Urgent Care) in Astoria, NY

NPI 1619465721 Organization Clinic/Center Urgent Care CLIA Number 33D2151053 CLIA Certificate of Waiver

About CITYMD URGENT CARE (CITY MEDICAL OF UPPER EAST SIDE, PLLC)

Citymd Urgent Care (city Medical Of Upper East Side, Pllc) is a provider established in Astoria, New York specializing in clinic/center (urgent care) . The NPI number of Citymd Urgent Care (city Medical Of Upper East Side, Pllc) is 1619465721 and was assigned on April 2018. The practitioner's primary taxonomy code is 261QU0200X. The provider is registered as an organization and their NPI record was last updated 4 years ago. The provider's is doing business as Citymd Urgent Care. The authorized official of this NPI record is Marlena Simpson Cpmsm (Director Of Credentialing)

The CLIA number of Citymd Urgent Care is 33D2151053 registered as a "physician office" facility with a CLIA Certificate of Waiver. This CLIA certificate is issued to Citymd Urgent Care to perform only waived tests. CLIA defines waived tests as simple tests with a low risk for an incorrect result. Waived tests include certain tests listed in CLIA regulations, tests cleared by the FDA for home use and tests approved by the FDA for waived status and that meet CLIA waiver criteria.

NPI

1619465721

Provider NameCITYMD URGENT CARE (CITY MEDICAL OF UPPER EAST SIDE, PLLC)
Provider Location Address2248 31ST ST ASTORIA, NY 11105
Provider Mailing Address1345 RXR PLZ FL 13 UNIONDALE, NY 11556
NPI Entity TypeOrganization
Is Sole Proprietor?N/A
Is Organization Subpart?Yes
Other Organization NameCITYMD URGENT CARE
Other Name TypeDoing Business As (3)
Enumeration Date04-24-2018
Last Update Date04-24-2018


Primary Taxonomy

Taxonomy Code261QU0200X
ClassificationClinic/Center
TypeAmbulatory Health Care Facilities
SpecializationUrgent Care

Business Address

CITYMD URGENT CARE
2248 31ST ST
ASTORIA, NY
ZIP 11105
Phone: (718) 571-9192
Fax: (718) 571-9204

Get Directions


Mailing Address

CITYMD URGENT CARE
1345 RXR PLZ FL 13
UNIONDALE, NY
ZIP 11556
Phone: (516) 783-4600
Fax: (646) 846-3283



Authorized Official

Authorized Official Name MARLENA SIMPSON CPMSM
Authorized Official TitleDIRECTOR OF CREDENTIALING
Authorized Official Phone(516) 786-4300

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 the NPI number 1619465721 is:

CLIA Number33D2151053
Facility TypePHYSICIAN OFFICE
Certificate TypeCertificate of Waiver

Other Providers at the same location


The following 2 providers are registered at the same or nearby location.

NPI Name / Type Taxonomy Address
1902169832 LYNN S CHUNG MD
Individual
Family Medicine2248 31ST ST
ASTORIA, NY 11105
(516) 453-0435
1972175024DR. STEPHANIE TITUANA OD
Individual
Optometrist2248 31ST ST
ASTORIA, NY 11105
(718) 267-1333

NPI Footnotes

What is the National Provider Indentifier (NPI)?
The NPI is 10-position all-numeric identification number assigned by the NPPES to uniquely identify a health care provider.

Provider Location Address
The location address of the provider being identified. For providers with more than one physical location, this is the primary location. This address cannot include a Post Office box.

Provider Mailing Address
The mailing address of the provider being identified. This address may contain the same information as the provider location address.

Entity Type Code
The code describing the type of health care provider that is being assigned an NPI.
The entity type codes are:
1 = Person: individual human being who furnishes health care;
2 = Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)

What is a Subpart?
Subparts are the components and separate physical locations of organization health care providers. Subpart examples include:
Hospital components include outpatient departments, surgical centers, psychiatric units, and laboratories. These components are often separately licensed or certified by States and may exist at physical locations other than that of the hospital of which they are a component.

Provider Other Organization Name
The other organization name is the alternative last name by which the provider is or has been known (if an individual) or other name by which the organization provider is or has been known. The code identifying the type of other name. The provider other organization name codes are:
1 = former name;
2 = professional name;
3 = doing business as (d/b/ a) name;
4 = former legal business name; :
5 = other.

Provider Enumeration Date
The date the provider was assigned a unique identifier (assigned an NPI).

Last Update Date
The date that a NPI record was last updated or changed.

Primary Taxonomy Code
The primary taxonomy code defines the provider type, classification, and specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.

Authorized Official Name
The name of the person authorized to submit the NPI application or to officially change data for a health care provider.