Organization Active NPI

Bay Physmed, P.C.

  • Physical Medicine & Rehabilitation Physician
  • Brooklyn, NY
National Provider Identifier
1033145149
Registry record updated Feb 20, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Medicine & Rehabilitation PhysicianTaxonomy code 208100000X
License
2013071 Issued in NY
Legal business name
BAY PHYSMED, P.C.
Practice address
2736 Ocean Ave
Suite 1a
Brooklyn, NY 11229
Phone
(718) 837-4466
Fax
(718) 837-1179
NPI assigned
Jun 23, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 20, 2010

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

Authorized official

Name
Viktoriya Brener, M.D.NPI 1457321655
Title
Doctor
Phone
(718) 837-4466

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Medicine & Rehabilitation PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 208100000X 2013071 NY Primary

Addresses

Primary practice location

2736 Ocean Ave
Suite 1a
Brooklyn, NY 11229

Mailing address

2736 Ocean Ave
Suite 1a
Brooklyn, NY 11229
Phone (718) 837-4466

Other identifiers 1

IdentifierTypeStateIssuer
01693690MedicaidNY

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20070510000165 NY Part B Supplier - Clinic/Group Practice 4880790682 Receives reassigned benefits from 2 practitioners
Practice locations: Brooklyn, NY

National Provider Directory

National Provider Directory

Locations

10 Downing St
New York, NY 10014
Phone (212) 243-1644

Practitioners & affiliated clinicians

Practitioners 6

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": "1151020800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1266624000000",
    "number": "1033145149",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2736 OCEAN AVE",
            "address_2": "SUITE 1A",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "11229",
            "telephone_number": "718-837-4466",
            "fax_number": "718-837-1179"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2736 OCEAN AVE",
            "address_2": "SUITE 1A",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "11229",
            "telephone_number": "718-837-4466",
            "fax_number": "718-837-1179"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BAY PHYSMED, P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-23",
        "last_updated": "2010-02-20",
        "status": "A",
        "authorized_official_last_name": "BRENER",
        "authorized_official_first_name": "VIKTORIYA",
        "authorized_official_title_or_position": "DOCTOR",
        "authorized_official_telephone_number": "718-837-4466",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "208100000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physical Medicine & Rehabilitation",
            "state": "NY",
            "license": "2013071",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01693690",
            "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 20, 2010; 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.