NPIMap

Organization Active NPI

Jal 28 LLC

Doing business as A Merryland Health Center

  • Clinic/Center
  • Brooklyn, NY
National Provider Identifier
1063278281
Registry record updated Feb 26, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinic/CenterTaxonomy code 261Q00000X
Legal business name
JAL 28 LLC
Doing business as
A Merryland Health Center
Practice address
2873 W 17TH St
Brooklyn, NY 11224-2611
Phone
(718) 265-0900
NPI assigned
Feb 26, 2024
Last updated
Feb 26, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 26, 2024

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

Authorized official

Name
John Lieberman
Title
Manager
Phone
(917) 747-7976

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinic/Center 261Q00000X NU Primary

Addresses

Primary practice location

2873 W 17TH St
Brooklyn, NY 11224-2611

Mailing address

2873 W 17TH St
Brooklyn, NY 11224-2611

Other names 1

  • A Merryland Health Center Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20240731000953 NY Part B Supplier - Clinic/Group Practice 5193262830 Receives reassigned benefits from 20 practitioners
Practice locations: Brooklyn, NY

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 80

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 80

NPI Registry JSON

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

{
    "created_epoch": "1708905600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1708905600000",
    "number": "1063278281",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2873 W 17TH ST",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112242611"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2873 W 17TH ST",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112242611",
            "telephone_number": "718-265-0900"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JAL 28 LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-02-26",
        "last_updated": "2024-02-26",
        "certification_date": "2024-02-25",
        "status": "A",
        "authorized_official_last_name": "LIEBERMAN",
        "authorized_official_first_name": "JOHN",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "917-747-7976"
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "A Merryland Health Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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 26, 2024; 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.