| Progressive Care Medical Group, Pllc | |
|
150 Eileen Way Unit 1 Syosset NY 11791-5313 | |
| (516) 855-5255 | |
| (516) 921-2451 |
| Full Name | Progressive Care Medical Group, Pllc |
|---|---|
| Speciality | Internal Medicine |
| Location | 150 Eileen Way Unit 1, Syosset, New York |
| Authorized Official Name and Position | Melissa Messite (DIRECTOR OF OPERATIONS) |
| Authorized Official Contact | 5168555255 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Progressive Care Medical Group, Pllc 150 Eileen Way Unit 1 Syosset NY 11791-5313 Ph: (516) 855-5255 | Progressive Care Medical Group, Pllc 150 Eileen Way Unit 1 Syosset NY 11791-5313 Ph: (516) 855-5255 |
| NPI Number | 1295263796 |
|---|---|
| Provider Enumeration Date | 05/27/2017 |
| Last Update Date | 07/26/2022 |
| Medicare PECOS PAC ID | 7113298209 |
|---|---|
| Medicare Enrollment ID | O20170808002403 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1295263796 | NPI | - | NPPES |
| Provider Name | Olusegun Ogunfowora |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1275602963 PECOS PAC ID: 4789578535 Enrollment ID: I20040211001197 |
| Provider Name | Abiola Familusi |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1649351214 PECOS PAC ID: 5890608079 Enrollment ID: I20041012000584 |
| Provider Name | Karen Stanford |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1568554053 PECOS PAC ID: 8325091416 Enrollment ID: I20050301000597 |
| Provider Name | Marie A Bernard |
|---|---|
| Provider Type | Practitioner - Infectious Disease |
| Provider Identifiers | NPI Number: 1093750127 PECOS PAC ID: 0446253728 Enrollment ID: I20060808000127 |
| Provider Name | Gabriela Rosas Garcia |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1316148265 PECOS PAC ID: 9638268410 Enrollment ID: I20071130000542 |
| Provider Name | Sung Whang |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1982800900 PECOS PAC ID: 7810070828 Enrollment ID: I20080214000323 |
| Provider Name | Ammir S Rabadi |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1578746350 PECOS PAC ID: 8527133644 Enrollment ID: I20080823000050 |
| Provider Name | Roxanne Chase-wiley |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1336395532 PECOS PAC ID: 3779626288 Enrollment ID: I20100205000507 |
| Provider Name | Asani I Phillips |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1740477132 PECOS PAC ID: 1759573132 Enrollment ID: I20101004000698 |
| Provider Name | Rajan Dey |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1568783652 PECOS PAC ID: 5193996510 Enrollment ID: I20110915000352 |
| Provider Name | Mohammad F Ellahi |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1750619722 PECOS PAC ID: 6002087988 Enrollment ID: I20110926000676 |
| Provider Name | Christopher M Glenn |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1982971180 PECOS PAC ID: 3476729716 Enrollment ID: I20120109000051 |
| Provider Name | George Samuel |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1407087307 PECOS PAC ID: 8426208950 Enrollment ID: I20140124001765 |
| Provider Name | Aized Imtiaz |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1124212758 PECOS PAC ID: 5294900544 Enrollment ID: I20150429001739 |
| Provider Name | Anthony Salem |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1386083608 PECOS PAC ID: 9133408115 Enrollment ID: I20161115001078 |
| Provider Name | Miok Lim-drakatos |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1043762800 PECOS PAC ID: 7416237227 Enrollment ID: I20161214000946 |
| Provider Name | Mili Biju |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1558882522 PECOS PAC ID: 3971873811 Enrollment ID: I20170725003347 |
| Provider Name | Choudhury M Hasan |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1669850210 PECOS PAC ID: 5991042418 Enrollment ID: I20190122003021 |
| Provider Name | Yocheved Fogel |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1740845825 PECOS PAC ID: 9436482197 Enrollment ID: I20190612000058 |
| Provider Name | Katie Louise Kwaschyn |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1659650257 PECOS PAC ID: 3779870084 Enrollment ID: I20191001001842 |
| Provider Name | Fahad Pervez |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1144635350 PECOS PAC ID: 0143522615 Enrollment ID: I20200720001467 |
| Provider Name | Ci Ai Li |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1669024691 PECOS PAC ID: 8224365374 Enrollment ID: I20200729003650 |
| Provider Name | Craig Christopher Bhoorasingh |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1275996878 PECOS PAC ID: 5597175935 Enrollment ID: I20201113001057 |
| Provider Name | Valerie Cantave |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1568063378 PECOS PAC ID: 4688086879 Enrollment ID: I20201211001408 |
| Provider Name | Daniel Anertey Abbey |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1063867687 PECOS PAC ID: 8628482130 Enrollment ID: I20210125001284 |
| Provider Name | Shaheda N Moore |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1669036323 PECOS PAC ID: 6901131127 Enrollment ID: I20220527000528 |
| Provider Name | Sumyyia Usman |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1700510609 PECOS PAC ID: 7517341571 Enrollment ID: I20220825001989 |
| Provider Name | Kyle C O'rourke |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1467972422 PECOS PAC ID: 0446626139 Enrollment ID: I20221020002901 |
| Provider Name | Romana Amjad |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1588331888 PECOS PAC ID: 6103294467 Enrollment ID: I20221118000158 |
| Provider Name | Radim Jacob |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1669935128 PECOS PAC ID: 2163759135 Enrollment ID: I20230526001564 |
| Provider Name | Chloe Smith |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1841872389 PECOS PAC ID: 4587010863 Enrollment ID: I20231115001583 |
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