Amboy Medical Practice PC
NPI 1104692672 · Diagnostic Radiology Physician · Staten Island, NY
Enrolled with Medicare as Part B Supplier - Clinic/Group Practice · source: CMS PECOS Public Provider Enrollment (2026.04.01)
Amboy Medical Practice PC is a Diagnostic Radiology Physician organization in Staten Island, NY (NPI 1104692672).
Provider details
- NPI number
- 1104692672
- Entity type
- Organization
- Primary specialty
- Diagnostic Radiology PhysicianAllopathic & Osteopathic Physicians
- Organization subpart
- No
- Authorized official
- Joan Nelson, Director Network Revenue Cycle Oper(718) 818-4531
Specialties & taxonomies
Allopathic & Osteopathic Physicians
- Body Imaging Physician2085B0100X
Allopathic & Osteopathic Physicians
Allopathic & Osteopathic Physicians
- Nuclear Radiology Physician2085N0904X
Allopathic & Osteopathic Physicians
- Pediatric Radiology Physician2085P0229X
Allopathic & Osteopathic Physicians
- Radiation Oncology Physician2085R0001X
Allopathic & Osteopathic Physicians
Profile Score
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
2 yrs in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
5 documented practice locations
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
Mailing address
Additional practice locations (4)
- 1161 Victory BlvdStaten Island, NY 10301-3621Phone: (718) 818-1161Fax: (855) 451-7988
- 1000 South AveStaten Island, NY 10314-3409Phone: (718) 816-4949Fax: (718) 370-8731
- 1058 Forest AveStaten Island, NY 10310-2419Phone: (718) 818-1058Fax: (855) 449-6480
- 4360 Hylan BlvdStaten Island, NY 10312-6522Phone: (718) 818-4360Fax: (718) 317-9134
Registry dates
- Enumerated
- 2023-11-27
- Last updated
- 2023-11-27
- Certified
- 2023-11-27
Frequently asked questions
- What is Amboy Medical Practice PC's NPI number?
- Amboy Medical Practice PC's National Provider Identifier (NPI) is 1104692672, a unique 10-digit ID issued by CMS for use in standard healthcare transactions.
- What type of organization is Amboy Medical Practice PC?
- Amboy Medical Practice PC is classified in the NPPES registry as Diagnostic Radiology Physician (Allopathic & Osteopathic Physicians).
- Where is Amboy Medical Practice PC located?
- Amboy Medical Practice PC's practice location on file with NPPES is 355 Bard Ave, Staten Island, NY 10310-1664.
- What is Amboy Medical Practice PC's phone number?
- The practice phone number listed in the NPPES registry for Amboy Medical Practice PC is (718) 818-1234.
- Does Amboy Medical Practice PC accept Medicare?
- Amboy Medical Practice PC is approved to bill Medicare according to CMS PECOS enrollment data (2026.04.01). Confirm current participation with the provider before scheduling.
- Who is the authorized official for Amboy Medical Practice PC?
- The authorized official listed on Amboy Medical Practice PC's NPPES record is Joan Nelson, Director Network Revenue Cycle Oper. The authorized official registers and maintains the organization's NPI and is not necessarily its owner.
- Is Amboy Medical Practice PC's NPI active?
- Yes — Amboy Medical Practice PC's NPI (1104692672) is active in the NPPES registry as of the last update on 2023-11-27.
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.