Atlantic Surgical Supply Corp

Primary specialty

Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X

License

1038093 Issued in NY

Legal business name

ATLANTIC SURGICAL SUPPLY CORP

Practice address

3338 Nostrand Ave
Brooklyn, NY 11229-3715

Phone

(718) 236-5354

Fax

(718) 236-2156

NPI assigned

Aug 4, 2006

Last updated

Aug 22, 2020By 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

Mr. Oleg Movsumov

Title

President

Phone

(718) 236-5354

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in NY

Enrollment records 1

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

Medicare medical equipment & supply locations

Locations

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

{
    "created_epoch": "1154649600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1093723058",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3338 NOSTRAND AVE",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112293715",
            "telephone_number": "718-236-5354",
            "fax_number": "718-236-2156"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3338 NOSTRAND AVE",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112293715",
            "telephone_number": "718-236-5354",
            "fax_number": "718-236-2156"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ATLANTIC SURGICAL SUPPLY CORP",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-04",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "MOVSUMOV",
        "authorized_official_first_name": "OLEG",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "718-236-5354",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "NY",
            "license": "1038093",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02519886",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Providers in Brooklyn, NY by specialty
• Durable Medical Equipment & Medical Supplies in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.