NPIMap

Organization Active NPI

Maimonides Medical Center Maimonides Primary Care FPP

  • Internal Medicine Physician
  • Brooklyn, NY
National Provider Identifier
1013968593
Registry record updated Feb 13, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
Legal business name
MAIMONIDES MEDICAL CENTER MAIMONIDES PRIMARY CARE FPP
Practice address
1250 57TH St
Brooklyn, NY 11219-4537
Phone
(718) 283-7732
NPI assigned
May 12, 2006
Last updated
Feb 13, 2013By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 13, 2013

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

Authorized official

Name
Dr. Edgar Lichstein, M.D.
Title
Chairman
Phone
(781) 283-7732

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207R00000X Primary

Addresses

Primary practice location

1250 57TH St
Brooklyn, NY 11219-4537

Mailing address

PO Box 27358
New York, NY 10087-7358

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040322000161 NY Part B Supplier - Clinic/Group Practice 5991696916 Receives reassigned benefits from 86 practitioners
Practice locations: Brooklyn, NY

National Provider Directory

National Provider Directory

Locations

1911 Avenue L
Brooklyn, NY 11230
Phone (718) 859-3499

4702 Fort Hamilton Pkwy
Brooklyn, NY 11219
Phone (718) 283-7949

Practitioners & affiliated clinicians

Practitioners 162

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.

View all 162

NPI Registry JSON

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

{
    "created_epoch": "1147392000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1360713600000",
    "number": "1013968593",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 27358",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100877358"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1250 57TH ST",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112194537",
            "telephone_number": "718-283-7732"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MAIMONIDES MEDICAL CENTER MAIMONIDES PRIMARY CARE FPP",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-12",
        "last_updated": "2013-02-13",
        "status": "A",
        "authorized_official_last_name": "LICHSTEIN",
        "authorized_official_first_name": "EDGAR",
        "authorized_official_title_or_position": "CHAIRMAN",
        "authorized_official_telephone_number": "781-283-7732",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "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 Feb 13, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.