Bushwick Professional Medical Services of New York LLC

Primary specialty

Vascular Surgery PhysicianTaxonomy code 2086S0129X

Legal business name

BUSHWICK PROFESSIONAL MEDICAL SERVICES OF NEW YORK LLC

Practice address

441 Knickerbocker Ave Ste a
Brooklyn, NY 11237-4508

Phone

(347) 773-2684

Fax

(718) 261-3893

NPI assigned

Jul 20, 2018

Last updated

Jul 20, 2018By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Yan KatsnelsonNPI 1285672840

Title

Owner

Phone

(224) 318-0118

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in NY

Enrollment records 1

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Locations

Practitioners 31

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Jeffrey Craig Hellinger, MD

  • Diagnostic Radiology Physician
  • New York, NY
  • NPI 1861443350
  Medicare reassignment Care Compare group NPD
• Masahiko Satoda, MD

  • Phlebology Physician
  • Brooklyn, NY
  • NPI 1841031648
  Medicare reassignment Care Compare group NPD
• Randi Harris, M.D.

  • Vascular Surgery Physician
  • Rochester, MN
  • NPI 1376997536

  NY

  Medicare reassignment Care Compare group NPD
• Yan Katsnelson, M.D.

  • Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
  • Elk Grove Village, IL
  • NPI 1285672840

  NY

  Medicare reassignment NPD Authorized official
• Sanjeev Saxena, MD

  • Cardiovascular Disease Physician
  • Zephyrhills, FL
  • NPI 1093701120

  NY, Single Specialty

  Medicare reassignment Care Compare group NPD
• Peter L Smith, M.D.

  • Vascular & Interventional Radiology Physician
  • Bayonne, NJ
  • NPI 1861497224

  NY

  Medicare reassignment Care Compare group NPD
• Michael C Banker, MD

  • Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
  • Brooklyn, NY
  • NPI 1033157169
  Medicare reassignment NPD
• Stuart L Blackwood, M.D.

  • Vascular Surgery Physician
  • Syracuse, NY
  • NPI 1730321761
  Medicare reassignment NPD
• Dallas Broadway, M.D.

  • Diagnostic Radiology Physician
  • New York, NY
  • NPI 1366646416
  Medicare reassignment NPD
• Richard Di Fiore, MD

  • Vascular Surgery Physician
  • Astoria, NY
  • NPI 1902000995
  Medicare reassignment NPD
• Glenn Rory Faust, MD

  • Vascular Surgery Physician
  • East Meadow, NY
  • NPI 1003986456
  Medicare reassignment NPD
• Alexander Gart, MD

  • Vascular Surgery Physician
  • New York, NY
  • NPI 1376610758
  Medicare reassignment NPD

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1532044800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1532044800000",
    "number": "1003393299",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 32",
            "city": "NORTHBROOK",
            "state": "IL",
            "postal_code": "600650032",
            "telephone_number": "847-593-8460",
            "fax_number": "224-235-4652"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "441 KNICKERBOCKER AVE STE A",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112374508",
            "telephone_number": "347-773-2684",
            "fax_number": "718-261-3893"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BUSHWICK PROFESSIONAL MEDICAL SERVICES OF NEW YORK LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-07-20",
        "last_updated": "2018-07-20",
        "status": "A",
        "authorized_official_last_name": "KATSNELSON",
        "authorized_official_first_name": "YAN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "224-318-0118"
    },
    "taxonomies": [
        {
            "code": "2086S0129X",
            "taxonomy_group": "",
            "desc": "Surgery, Vascular Surgery",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Bushwick Economic Development Corp
• Bushwick Medical of New York LLC
• Bushwick Orthodontic Studio
• Bushwick Orthodontics PLLC (Diamond Braces)
• Bushwick Pharmacy, Inc.
• Bushwick Quality Supplies LLC
• Bushwick Stuyvesant Heights Home Attendants, Inc.
• Bushwick Therapy Mental Health Counseling, PLLC
• Yamit Busidan, DO
• Barbara Adelia Busillo, LCSW

• Vascular Surgery Physician in Brooklyn, NY
• Providers in Brooklyn, NY by specialty
• Vascular Surgery Physician in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 20, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.