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
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

Other identifiers 1

IdentifierTypeStateIssuer
01746785MedicaidNY

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

1401 Newkirk Ave
Brooklyn, NY 11226
Phone (718) 283-1600

4719 Fort Hamilton Pkwy
Brooklyn, NY 11219
Phone (718) 283-7089

648 Bay Ridge Pkwy
Brooklyn, NY 11209
Phone (718) 748-1197

4802 10th Ave
New York, NY 10087

Practitioners & affiliated clinicians

Practitioners 162

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

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": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01746785",
            "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 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.