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MAGNOLIA MEDICAL PC
NPI 1619657665
Internal Medicine in Mount Vernon, NY

Active since July 24, 2023CLIA 33D2289718 · Waiver
11 PARK AVE APT 1K, MOUNT VERNON, NY 10550(914) 668-6140(914) 663-8745 Get Directions Write a Review

NPPES record last updated: July 24, 2023. Verified against the NPPES registry weekly; last sync: August 09, 2026.

About Magnolia Medical Pc NPPES

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

MAGNOLIA MEDICAL PC (NPI 1619657665) is a healthcare organization registered as an internal medicine in Mount Vernon, New York and active in the NPI registry since July 2023. The organization holds a CLIA Waiver certificate valid through September 13, 2027 and lists Sonal Patel, Owner, as its authorized official.

NPPES Registry Identity

NPI1619657665
Entity TypeOrganization
Primary Taxonomy207R00000X
Legal Business NameMAGNOLIA MEDICAL PC
Location Address11 PARK AVE APT 1KMount Vernon, NY 10550-2164
Mailing Address11 Park Ave Apt 1kMount Vernon, NY 10550-2164 · (914) 668-6140 · Fax (914) 663-8745
Phone(914) 668-6140
Fax(914) 663-8745
Organization SubpartNo
Authorized OfficialSonal PatelOwner · (914) 584-6823
Enumeration DateJuly 24, 2023
NPPES CertifiedJuly 24, 2023
✔ NPI 1619657665 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyInternal MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207R00000X
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.
11 PARK AVE APT 1K, Mount Vernon, NY 10550
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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 33D2289718

Magnolia Medical PC · Mount Vernon, NY
Active · expires Sep 13, 2027
CLIA Number33D2289718
Laboratory TypePhysician Office
Certificate Effective DateSeptember 14, 2025
Certificate Expiration DateSeptember 13, 2027
Laboratory DirectorDr. Sonal Patel
Laboratory Phone(914) 668-6140
Laboratory LocationMagnolia Medical PC11 Park Ave, Suite 1K, Mount Vernon, NY 10550
CLIA data matches this NPI record on: Name Phone
This certificate is issued to a laboratory to perform only waived tests.

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 Magnolia Medical PC's NPI number?

The NPI number for Magnolia Medical PC is 1619657665. It was assigned to this organization in the NPPES registry on July 24, 2023.

Where is Magnolia Medical PC located?

Magnolia Medical PC is located at 11 Park Ave Apt 1K, Mount Vernon, NY 10550. The listed phone number is (914) 668-6140.

What is Magnolia Medical PC's specialty?

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

Does Magnolia Medical PC hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 33D2289718) is associated with this NPI, valid through September 13, 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 Magnolia Medical PC was last updated on July 24, 2023. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 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.