1110 PENNSYLVANIA AVENUE MEDICAL PLLC
NPI 1730638115
Clinic/Center - Urgent Care in Brooklyn, NY
NPI Status: Active since September 27, 2016
Contact Information
1110 PENNSYLVANIA AVE
SUITE 5
BROOKLYN, NY
ZIP 11207
Phone: (646) 942-2842
- Organization
- Clinic/Center
- Urgent Care
- CLIA Number: 33D2120875
- CLIA Cert. Type: Physician Office
- CLIA Exp. Date: 10-25-2026
About 1110 PENNSYLVANIA AVENUE MEDICAL PLLC
This page provides the complete NPI Profile along with additional information for 1110 Pennsylvania Avenue Medical Pllc, a provider established in Brooklyn, New York operating as a Clinic/center, focusing in urgent care . The healthcare provider is registered in the NPI registry with number 1730638115 assigned on September 2016. The practitioner's primary taxonomy code is 261QU0200X. The provider is registered as an organization and their NPI record was last updated 10 years ago. The authorized official of this NPI record is Dr. Jacqueline Storey Md (Physician)
- NPI
- 1730638115
- Provider Name
- 1110 PENNSYLVANIA AVENUE MEDICAL PLLC
- Entity Type
- Organization
- Location Address
- 1110 PENNSYLVANIA AVE SUITE 5 BROOKLYN, NY 11207
- Location Phone
- (646) 942-2842
- Mailing Address
- 1110 PENNSYLVANIA AVE SUITE 5 BROOKLYN, NY 11207
- Mailing Phone
- (646) 942-2842
- Is Sole Proprietor?
- No
- Is Organization Subpart?
- No
- Enumeration Date
- 09-27-2016
- Last Update Date
- 10-05-2016
- 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
Clinic/Center Urgent Care
- Taxonomy Code
- 261QU0200X
- Type
- Ambulatory Health Care Facilities
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
- 33D2120875
- Facility Type
- Physician Office
- Certificate Effective Date
- October 26, 2024
- Certificate Expiration Date
- October 25, 2026
- Laboratory Director
- DR. JASON SHEVETZ
- Certificate Type
- Certificate of Waiver
- Certificate Type Description
- This CLIA certificate is issued to 1110 Pennsylvania Avenue Medical Pllc 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.
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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 1730638115, we treat the final digit (5) 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 55. The final step is to find the difference between that total and the next multiple of ten (60 - 55 = 5).
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 55 is 60. The difference is the calculated check digit.
Other Providers at the Same Location
The following 15 providers are registered at the same or a nearby location.
BROOKLYN, NY 11207
BROOKLYN, NY 11207
BROOKLYN, NY 11207
Frequently Asked Questions
The NPI number assigned to this healthcare provider is 1730638115, enumerated as an "organization" on September 27, 2016.
The provider is located at 1110 PENNSYLVANIA AVE SUITE 5 BROOKLYN, NY 11207 and the phone number is (646) 942-2842.
Clinic/Center with taxonomy code 261QU0200X and a focus in Urgent Care.
