VICTORY MEDICAL GROUP PLLC
NPI 1912223280
Family Medicine in Staten Island, NY
About Victory Medical Group Pllc NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
VICTORY MEDICAL GROUP PLLC (NPI 1912223280) is a healthcare organization registered as a family medicine in Staten Island, New York and active in the NPI registry since April 2010. The organization lists Omar Klobocista, Medical Doctor, 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)
Victory Medical Group 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 Victory Medical Group PLLC, 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 Victory Medical Group PLLC's NPI number?
The NPI number for Victory Medical Group PLLC is 1912223280. It was assigned to this organization in the NPPES registry on April 12, 2010.
Where is Victory Medical Group PLLC located?
Victory Medical Group PLLC is located at 220 Victory Blvd, Staten Island, NY 10301. The listed phone number is (718) 447-1080.
What is Victory Medical Group PLLC's specialty?
The primary specialty registered for this NPI is Family Medicine with taxonomy code 207Q00000X.
Is Victory Medical Group PLLC enrolled in Medicare?
Yes. Victory Medical Group PLLC is registered in the Medicare PECOS enrollment system.
How many clinicians bill Medicare through Victory Medical Group PLLC?
According to the CMS Revalidation Reassignment List (October 2026 release), 1 clinician (Family Practice) reassigns their Medicare billing to Victory Medical Group 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.
When was this NPI record last updated?
The NPPES record for Victory Medical Group PLLC was last updated on January 12, 2022. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 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.
# Victory Medical Group Pllc · NPI 1912223280
Family Medicine organization in Staten Island, New York. Organization record, active in the CMS NPPES registry since April 12, 2010.
## Identity
- **NPI:** 1912223280 (Entity type: Organization)
- **Enumerated:** April 12, 2010
- **Primary specialty:** Family Medicine · taxonomy 207Q00000X
- **Organization subpart:** No
- **Authorized official:** Omar Klobocista, MEDICAL DOCTOR
## Practice location
- **Address:** 220 VICTORY BLVD, Staten Island, NY 10301-2919
- **Phone:** (718) 447-1080 · **Fax:** (718) 447-1559
## 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:** January 12, 2022
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Source: [NPI Profile](https://npiprofile.com/npi/1912223280) · Data from the CMS NPPES public registry.