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PHOENIX MEDICAL OFFICE PLLC
NPI 1770919466
Internal Medicine - Geriatric Medicine in Elmhurst, NY

Active since September 25, 2013CLIA 33D2068720 · Waiver
5223 VAN LOON ST, ELMHURST, NY 11373(646) 943-1588 Get Directions Write a Review

NPPES record last updated: August 19, 2026. Verified against the NPPES registry weekly; last sync: October 18, 2026.

About Phoenix Medical Office Pllc NPPES

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

PHOENIX MEDICAL OFFICE PLLC (NPI 1770919466) is a healthcare organization registered as a geriatric medicine in Elmhurst, New York and active in the NPI registry since September 2013. The organization holds a CLIA Waiver certificate valid through November 11, 2027 and lists Kyawt Thandar Aung, President, as its authorized official.

NPPES Registry Identity

NPI1770919466
Entity TypeOrganization
Primary Taxonomy207RG0300X
Legal Business NamePHOENIX MEDICAL OFFICE PLLC
Location Address5223 VAN LOON STElmhurst, NY 11373-4258
Mailing Address19614 58th Ave # 1fFresh Meadows, NY 11365-2306 · (646) 899-5144
Phone(646) 943-1588
Organization SubpartNo
Authorized OfficialKyawt Thandar AungPresident · (646) 899-5144
Enumeration DateSeptember 25, 2013
Last NPPES UpdateAugust 19, 2026
NPPES CertifiedAugust 19, 2026
✔ NPI 1770919466 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyInternal Medicine · Geriatric MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207RG0300X
License✔ Licensed in NY · 241558
Definition
An internist who has special knowledge of the aging process and special skills in the diagnostic, therapeutic, preventive and rehabilitative aspects of illness in the elderly. This specialist cares for geriatric patients in the patient's home, the office, long-term care settings such as nursing homes and the hospital.
5223 VAN LOON ST, Elmhurst, NY 11373
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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

Medicare Participation & PECOS CMS

Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Phoenix Medical Office Pllc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Clinicians Billing Medicare Through This Organization

Medicare enrollment records show 1 clinician reassigns Medicare billing to Phoenix Medical Office PLLC, which bills Medicare for the services this clinician delivers.

Clinician (1)

Kyawt Aung, M.D.
Internal Medicine
NPI 1548424963
5223 VAN LOON ST
Elmhurst, NY 11373
(718) 424-6741
✔ PECOSSame address

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

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 33D2068720

Phoenix Medical Office PLLC · Elmhurst, NY
Active · expires Nov 11, 2027
CLIA Number33D2068720
Laboratory TypePhysician Office
Certificate Effective DateNovember 12, 2025
Certificate Expiration DateNovember 11, 2027
Laboratory DirectorDr. Kyawt T. Aung
Laboratory Phone(646) 943-1588
Laboratory LocationPhoenix Medical Office PLLC52-23 Van Loon Street, Elmhurst, NY 11373
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 Phoenix Medical Office PLLC's NPI number?

The NPI number for Phoenix Medical Office PLLC is 1770919466. It was assigned to this organization in the NPPES registry on September 25, 2013.

Where is Phoenix Medical Office PLLC located?

Phoenix Medical Office PLLC is located at 5223 Van Loon St, Elmhurst, NY 11373. The listed phone number is (646) 943-1588.

What is Phoenix Medical Office PLLC's specialty?

The primary specialty registered for this NPI is Internal Medicine, specializing in Geriatric Medicine, with taxonomy code 207RG0300X.

Is Phoenix Medical Office PLLC enrolled in Medicare?

Yes. Phoenix Medical Office PLLC is registered in the Medicare PECOS enrollment system.

How many clinicians bill Medicare through Phoenix Medical Office PLLC?

According to the CMS Revalidation Reassignment List (October 2026 release), 1 clinician (Internal Medicine) reassigns their Medicare billing to Phoenix Medical Office PLLC. 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. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Does Phoenix Medical Office PLLC hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 33D2068720) is associated with this NPI, valid through November 11, 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 Phoenix Medical Office PLLC was last updated on August 19, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 months 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.