NPIMap

Individual provider Active NPI

Jason Zimmerman, D.O.

  • Emergency Medicine Physician
  • Brooklyn, NY
National Provider Identifier
1073871067
Registry record updated Jul 21, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
267528 Issued in NY
Practice address
4802 10TH Ave
Brooklyn, NY 11219-2916
Phone
(718) 283-6167
NPI assigned
Apr 26, 2012
Last updated
Jul 21, 2015By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 21, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X 267528 NY Primary

Addresses

Primary practice location

4802 10TH Ave
Brooklyn, NY 11219-2916

Mailing address

4802 10TH Ave
Brooklyn, NY 11219-2916
Phone (718) 283-6167

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20141017001653 NY Practitioner - Internal MedicinePractitioner - Emergency Medicine 2860613775 Reassigns benefits to 6 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
New York College of Osteo Medicine of New York Institute of Technology, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Boro Park Operating Co LLCGroup PAC ID 3577751320, 7 clinicians

Practice addresses (Care Compare)

4915 10TH Ave
Brooklyn, NY 11219-3301
Phone (718) 851-3700

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
75 of 100Reported as individual

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

State licenses

LicenseStateTypeSpecialty
267528NYMDLicensed Practical Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
Maimonides Faculty Practice Plan CurrentSince Jul 1, 2015 Accepting new patients
Maimonides Medical Center Current Accepting new patients
Boro Park Operating Co LLC CurrentSince Jun 10, 2017 Accepting new patients
North Shore-Lij Medical PC Emergency Medicine CurrentSince Jul 1, 2014 Accepting new patients
North Shore - Lij Medical PC CurrentSince Jul 1, 2014 Accepting new patients
Patient First Medical Practice PC CurrentSince Jul 2, 2022 Accepting new patients
Medical Director Services PC CurrentSince Jul 24, 2025 Accepting new patients
Boro Park Operating Co LLC Past Accepting new patients

Locations

4915 10th Ave
Brooklyn, NY 11219
Phone (718) 851-3700

250 Skillman St
Ste 204
Brooklyn, NY 11205
Phone (513) 341-7173

50 Sheffield Ave
Brooklyn, NY 11207
Phone (718) 250-8789

4802 10th Ave
Brooklyn, NY 11219
Phone (718) 283-8724

1311 Virginia St
Far Rockaway, NY 11691
Phone (718) 327-2908

10201 66th Rd
Forest Hills, NY 11375
Phone (718) 830-4091

Networks

  • Healthfirst Medicare Network H1722
  • Healthfirst Medicare Network H9678
  • Healthfirst Medicare Network H5989
  • Healthfirst Medicare Network H3359

Interoperability endpoints

  • Direct secure messaging: jasonzimmerman@mai.allscriptsdirect.net

Ownership & related parties

All facility ownership & control disclosures 1

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Boro Park Center for Rehabilitation and Health CareBrooklyn, NY, CCN 335470 Skilled nursing facility Operational/Managerial Control
Adp of the SNF		 Aug 2, 2017
Aug 2, 2017

Owned or controlled facilities with NPI records 1

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

  • Boro Park Operating Co LLC

    dba Boro Park Center for Rehabilitation & Healthcare

    • Skilled Nursing Facility
    • Brooklyn, NY
    • NPI 1982913109

    Adp of the SNF, Operational/Managerial Control

    CMS ownership

Organizations & group practices 9

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 6

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1335398400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1437436800000",
    "number": "1073871067",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4802 10TH AVE",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112192916",
            "telephone_number": "718-283-6167"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4802 10TH AVE",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112192916",
            "telephone_number": "718-283-6167"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ZIMMERMAN",
        "first_name": "JASON",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2012-04-26",
        "last_updated": "2015-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "NY",
            "license": "267528",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brooklyn, NY

Sources for this page

Verify at the official NPI Registry.