{
  "npi": "1366208639",
  "enumeration_type": "NPI-2",
  "basic": {
    "authorized_official_first_name": "KAMRAN",
    "authorized_official_last_name": "SIDDIQUI",
    "authorized_official_telephone_number": "5166000676",
    "authorized_official_title_or_position": "Chief Executive Officer",
    "certification_date": "2025-09-19",
    "enumeration_date": "2024-02-26",
    "last_updated": "2025-09-19",
    "organization_name": "37 MAIN STREET MEDICAL CARE PC",
    "organizational_subpart": "NO",
    "status": "A"
  },
  "addresses": [
    {
      "address_1": "2094 MERRICK AVE",
      "address_purpose": "MAILING",
      "address_type": "DOM",
      "city": "MERRICK",
      "country_code": "US",
      "country_name": "United States",
      "fax_number": "718-709-4282",
      "postal_code": "115663147",
      "state": "NY",
      "telephone_number": "516-600-0676"
    },
    {
      "address_1": "2094 MERRICK AVE",
      "address_purpose": "LOCATION",
      "address_type": "DOM",
      "city": "MERRICK",
      "country_code": "US",
      "country_name": "United States",
      "fax_number": "516-863-2963",
      "postal_code": "115663147",
      "state": "NY",
      "telephone_number": "516-600-0676"
    }
  ],
  "taxonomies": [
    {
      "code": "208000000X",
      "desc": "Pediatrics",
      "license": null,
      "primary": false,
      "state": null,
      "taxonomy_group": "193200000X - Multi-Specialty Group"
    },
    {
      "code": "363LP2300X",
      "desc": "Nurse Practitioner, Primary Care",
      "license": null,
      "primary": false,
      "state": null,
      "taxonomy_group": "193200000X - Multi-Specialty Group"
    },
    {
      "code": "207Q00000X",
      "desc": "Family Medicine",
      "license": null,
      "primary": false,
      "state": null,
      "taxonomy_group": "193200000X - Multi-Specialty Group"
    },
    {
      "code": "363LF0000X",
      "desc": "Nurse Practitioner, Family",
      "license": null,
      "primary": false,
      "state": null,
      "taxonomy_group": "193200000X - Multi-Specialty Group"
    },
    {
      "code": "363L00000X",
      "desc": "Nurse Practitioner",
      "license": null,
      "primary": false,
      "state": null,
      "taxonomy_group": "193200000X - Multi-Specialty Group"
    },
    {
      "code": "363A00000X",
      "desc": "Physician Assistant",
      "license": null,
      "primary": false,
      "state": null,
      "taxonomy_group": "193200000X - Multi-Specialty Group"
    },
    {
      "code": "207R00000X",
      "desc": "Internal Medicine",
      "license": null,
      "primary": true,
      "state": null,
      "taxonomy_group": "193200000X - Multi-Specialty Group"
    }
  ],
  "compliance": {
    "oig_leie_exclusion": {
      "excluded": false,
      "status": "CLEAR",
      "matches": [],
      "totalDbRecords": 84224
    },
    "cms_pecos_eligibility": {
      "note": "Not listed in CMS Order & Referring PECOS file or institutional NPI-2"
    }
  },
  "medicare_utilization": null,
  "enrichment": {
    "plain_english_specialty": "Board-Certified Internist (Adult Diagnostic & Chronic Disease Physician)",
    "certifying_board": "American Board of Internal Medicine (ABIM)",
    "cms_medicare_crosswalk": [
      {
        "medicare_code": "11",
        "medicare_type": "Physician/Internal Medicine"
      }
    ]
  }
}