Organization Active NPI

Nephrology Foundation of Brooklyn

  • End-Stage Renal Disease (ESRD) Treatment Clinic/Center
  • Brooklyn, NY
National Provider Identifier
1013923473
Registry record updated Jun 27, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
End-Stage Renal Disease (ESRD) Treatment Clinic/CenterTaxonomy code 261QE0700X
License
7001249R Issued in NY
Legal business name
NEPHROLOGY FOUNDATION OF BROOKLYN
Practice address
63 Pennsylvania Ave
Brooklyn, NY 11207-2405
Phone
(718) 345-9000
NPI assigned
Jul 31, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 27, 2008

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

Authorized official

Name
Allen I Herman
Title
Ceo
Phone
(718) 857-3000

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
End-Stage Renal Disease (ESRD) Treatment Clinic/Center 261QE0700X 7001249R NY Primary

Addresses

Primary practice location

63 Pennsylvania Ave
Brooklyn, NY 11207-2405

Mailing address

63 Pennsylvania Ave
Brooklyn, NY 11207-2405

Other identifiers 1

IdentifierTypeStateIssuer
00457658MedicaidNY

National Provider Directory

National Provider Directory

Locations

342 Flatbush Ave
Brooklyn, NY 11238
Phone (718) 857-3000

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1154304000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1214524800000",
    "number": "1013923473",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "63 PENNSYLVANIA AVE",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112072405"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "63 PENNSYLVANIA AVE",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112072405",
            "telephone_number": "718-345-9000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NEPHROLOGY FOUNDATION OF BROOKLYN",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-31",
        "last_updated": "2008-06-27",
        "status": "A",
        "authorized_official_last_name": "HERMAN",
        "authorized_official_first_name": "ALLEN",
        "authorized_official_middle_name": "I",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "718-857-3000"
    },
    "taxonomies": [
        {
            "code": "261QE0700X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, End-Stage Renal Disease (ESRD) Treatment",
            "state": "NY",
            "license": "7001249R",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00457658",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Brooklyn, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 27, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.