VILLAGE FAMILY PRACTICE, PC
NPI 1902048911
Family Medicine in New York, NY
About Village Family Practice, Pc NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
VILLAGE FAMILY PRACTICE, PC (NPI 1902048911) is a healthcare organization registered as a family medicine in New York, New York and active in the NPI registry since April 2009. The organization lists Jerry Clements, President, as its authorized official.
NPPES Registry Identity
Specialties & Licenses
Group Practice 1
Medicare Participation & PECOS CMS
Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.
Medicare Enrollment Status
Enrolled in Medicare (PECOS)
Village Family Practice, Pc 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 Village Family Practice, PC, which bills Medicare for the services this clinician delivers.
Clinician (1)
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 Village Family Practice, PC's NPI number?
The NPI number for Village Family Practice, PC is 1902048911. It was assigned to this organization in the NPPES registry on April 6, 2009.
Where is Village Family Practice, PC located?
Village Family Practice, PC is located at 30 5th Ave, New York, NY 10011. The listed phone number is (212) 477-1750.
What is Village Family Practice, PC's specialty?
The primary specialty registered for this NPI is Family Medicine with taxonomy code 207Q00000X.
Is Village Family Practice, PC enrolled in Medicare?
Yes. Village Family Practice, PC is registered in the Medicare PECOS enrollment system.
How many clinicians bill Medicare through Village Family Practice, PC?
According to the CMS Revalidation Reassignment List (October 2026 release), 1 clinician (Family Practice) reassigns their Medicare billing to Village Family Practice, PC. 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.
When was this NPI record last updated?
The NPPES record for Village Family Practice, PC was last updated on April 22, 2010. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 16 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.
# Village Family Practice, Pc · NPI 1902048911
Family Medicine organization in New York, New York. Organization record, active in the CMS NPPES registry since April 6, 2009.
## Identity
- **NPI:** 1902048911 (Entity type: Organization)
- **Enumerated:** April 6, 2009
- **Primary specialty:** Family Medicine · taxonomy 207Q00000X
- **Organization subpart:** No
- **Authorized official:** Jerry Clements, PRESIDENT
## Practice location
- **Address:** 30 5TH AVE, New York, NY 10011-8859
- **Phone:** (212) 477-1750
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Clinicians billing through this organization:** 1 clinician (Family Practice) reassigns Medicare billing to this organization (form CMS-855R) · CMS Revalidation Reassignment List, October 2026 release
## Record status
- **NPPES last updated:** April 22, 2010
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Source: [NPI Profile](https://npiprofile.com/npi/1902048911) · Data from the CMS NPPES public registry.