1110 PENNSYLVANIA AVENUE MEDICAL PLLC
NPI 1730638115
Clinic/Center - Urgent Care in Brooklyn, NY
About 1110 Pennsylvania Avenue Medical Pllc NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
1110 PENNSYLVANIA AVENUE MEDICAL PLLC (NPI 1730638115) is a healthcare organization registered as an urgent care in Brooklyn, New York and active in the NPI registry since September 2016. The organization lists Jacqueline Storey, Physician, as its authorized official.
NPPES Registry Identity
Specialties & Licenses
Medicare Participation & PECOS CMS
Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.
Medicare Enrollment Status
Enrolled in Medicare (PECOS)
1110 Pennsylvania Avenue Medical Pllc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Clinicians Billing Medicare Through This Organization
3Medicare enrollment records show 3 clinicians reassign Medicare billing to 1110 Pennsylvania Avenue Medical PLLC, which bills Medicare for the services they deliver. Of these, 1 practice at this address and 2 within 10 miles. They are listed nearest first.
Clinicians, nearest first (3)
Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
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 1110 Pennsylvania Avenue Medical PLLC's NPI number?
The NPI number for 1110 Pennsylvania Avenue Medical PLLC is 1730638115. It was assigned to this organization in the NPPES registry on September 27, 2016.
Where is 1110 Pennsylvania Avenue Medical PLLC located?
1110 Pennsylvania Avenue Medical PLLC is located at 1110 Pennsylvania Ave Suite 5, Brooklyn, NY 11207. The listed phone number is (646) 942-2842.
What is 1110 Pennsylvania Avenue Medical PLLC's specialty?
The primary specialty registered for this NPI is Clinic/Center, specializing in Urgent Care, with taxonomy code 261QU0200X.
Is 1110 Pennsylvania Avenue Medical PLLC enrolled in Medicare?
Yes. 1110 Pennsylvania Avenue Medical PLLC is registered in the Medicare PECOS enrollment system.
How many clinicians bill Medicare through 1110 Pennsylvania Avenue Medical PLLC?
According to the CMS Revalidation Reassignment List (October 2026 release), 3 clinicians reassign their Medicare billing to 1110 Pennsylvania Avenue Medical PLLC, in Emergency Medicine, Family Practice and Internal Medicine. A reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for the clinician's services. Of these, 1 practice at this address and 2 within 10 miles. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
When was this NPI record last updated?
The NPPES record for 1110 Pennsylvania Avenue Medical PLLC was last updated on October 5, 2016. 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.
# 1110 Pennsylvania Avenue Medical Pllc · NPI 1730638115
Urgent Care organization in Brooklyn, New York. Organization record, active in the CMS NPPES registry since September 27, 2016.
## Identity
- **NPI:** 1730638115 (Entity type: Organization)
- **Enumerated:** September 27, 2016
- **Primary specialty:** Clinic/Center - Urgent Care · taxonomy 261QU0200X
- **Organization subpart:** No
- **Authorized official:** Jacqueline Storey, PHYSICIAN
## Practice location
- **Address:** 1110 PENNSYLVANIA AVE, SUITE 5, Brooklyn, NY 11207-9003
- **Phone:** (646) 942-2842
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Clinicians billing through this organization:** 3 clinicians in 3 Medicare specialties reassign Medicare billing to this organization (form CMS-855R); largest: Emergency Medicine (1), Family Practice (1), Internal Medicine (1); 1 practice at this address and 2 within 10 miles · CMS Revalidation Reassignment List, October 2026 release
## Record status
- **NPPES last updated:** October 5, 2016
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Source: [NPI Profile](https://npiprofile.com/npi/1730638115) · Data from the CMS NPPES public registry.