Intermed Care PC

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

Legal business name

INTERMED CARE PC

Practice address

721 Flushing Ave
Brooklyn, NY 11206-4419

Phone

(718) 218-6888

Fax

(718) 218-6855

NPI assigned

Aug 22, 2011

Last updated

Sep 16, 2011By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Boris Mazurov, MD

Title

Medical Director

Phone

(718) 331-9600

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in NY

Enrollment records 1

Other NPIs on the same Medicare enrollment 2

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

• Intermed Care PC

  • Legal Medicine
  • Brooklyn, NY
  • NPI 1144235516

  O20040315000371

  Same enrollment
• Intermed Care PC

  • Internal Medicine Physician
  • New York, NY
  • NPI 1356621445

  O20040315000371

  Same enrollment

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

{
    "created_epoch": "1313971200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1316131200000",
    "number": "1063792158",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1849 86TH ST",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112143108",
            "telephone_number": "718-331-9600",
            "fax_number": "718-331-9703"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "721 FLUSHING AVE",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112064419",
            "telephone_number": "718-218-6888",
            "fax_number": "718-218-6855"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "INTERMED CARE PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-08-22",
        "last_updated": "2011-09-16",
        "status": "A",
        "authorized_official_last_name": "MAZUROV",
        "authorized_official_first_name": "BORIS",
        "authorized_official_title_or_position": "MEDICAL DIRECTOR",
        "authorized_official_telephone_number": "718-331-9600",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "03324018",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Interfaith Medical Supply
• Interfaith Professional Physician Services, P.C. (OBH Physician Associates)
• Interfaith Psychiatry Services, P.C. (OBH Psychiatry & Mental Health)
• Interfaith Radiology
• Interhealth Medical Care PC
• Intermed Care PC
• Intermed Health Care Services, Inc.
• Intermed Medical Ny PC
• Intermed Medical PC
• Intermed Optical, Inc

• Internal Medicine Physician in Brooklyn, NY
• Providers in Brooklyn, NY by specialty
• Internal Medicine Physician in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 16, 2011; 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.