Individual provider Active NPI

Jon David Kirwin, M.D.

  • Vascular Surgery Physician
  • Brooklyn, NY
National Provider Identifier
1093783078
Registry record updated Mar 6, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Vascular Surgery PhysicianTaxonomy code 2086S0129X
License
160062 Issued in NY
Practice address
86 E 49TH St
Katz Building
Brooklyn, NY 11203-1901
Phone
(718) 288-1875
Fax
(212) 321-6101
NPI assigned
Mar 8, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 6, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Vascular Surgery Physician 2086S0129X 160062 NY Primary

Addresses

Primary practice location

86 E 49TH St
Katz Building
Brooklyn, NY 11203-1901

Mailing address

PO Box 3383
Church Street Station
New York, NY 10008-3383
Phone (718) 288-1875

Other identifiers 1

IdentifierTypeStateIssuer
01557735MedicaidNY

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040921001352 NY Practitioner - Vascular SurgeryPractitioner - General Surgery 7416925029 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Vascular SurgeryAlso: General Surgery
Education
Other, 1984
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Physician Affiliate Group of New York PCGroup PAC ID 4688098833, 1,222 clinicians
University Physicians of Brooklyn, Inc.Group PAC ID 0749192284, 174 clinicians

Practice addresses (Care Compare)

2601 Ocean Pkwy
Brooklyn, NY 11235-7745
Phone (718) 616-5356

450 Clarkson Ave
Brooklyn, NY 11203-2012
Phone (718) 270-1422

Hospital & facility affiliations

  • Suny/Downstate University Hospital of Brooklyn Hospital, Brooklyn, NY, CCN 330350
  • South Brooklyn Health Hospital, Brooklyn, NY, CCN 330196

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of nail tissue1-10

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
University Hospital of Brooklyn Suny Downstate Health Sciences Univers CurrentSince May 1, 2023 Accepting new patients
Physician Affiliate Group of New York PC CurrentSince Mar 1, 2024 Accepting new patients
University Physicians of Brooklyn, Inc. Vascular Surgery CurrentSince Dec 18, 2019 Accepting new patients
Coney Island Medical Practice Plan, P.C. CurrentSince Aug 28, 2015 Accepting new patients
University Physicians of Brooklyn, Inc. CurrentSince Dec 18, 2019 Accepting new patients
University Hospital of Brooklyn Suny Downstate Health Sciences Univers CurrentSince May 1, 2023 Accepting new patients
University Physicians of Brooklyn, Inc Past Accepting new patients

Locations

450 Clarkson Ave
#86
Brooklyn, NY 11203
Phone (718) 270-1396

450 Clarkson Ave
#80
Brooklyn, NY 11203
Phone (718) 613-8481

450 Clarkson Ave
Brooklyn, NY 11203
Phone (718) 270-1603

445 Lenox Rd
Brooklyn, NY 11203
Phone (718) 245-4790

2601 Ocean Pkwy
Brooklyn, NY 11235
Phone (718) 616-5354

470 Clarkson Ave
Brooklyn, NY 11203
Phone (718) 421-1003

506 Malcolm X Blvd
New York, NY 10037
Phone (212) 939-1000

Networks

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

Interoperability endpoints

  • Direct secure messaging: jkirwin145942@nychhc.direct-ci.com
  • Direct secure messaging: jonkirwin@sunydmc.allscriptsdirect.net
  • Direct secure messaging: jon.kirwin.1@438.direct.athenahealth.com

Organizations & group practices 7

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

Hospital & facility affiliations 2

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": "1141776000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1204761600000",
    "number": "1093783078",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 3383",
            "address_2": "CHURCH STREET STATION",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100083383",
            "telephone_number": "718-288-1875",
            "fax_number": "212-321-6101"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "86 E 49TH ST",
            "address_2": "KATZ BUILDING",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112031901",
            "telephone_number": "718-288-1875",
            "fax_number": "212-321-6101"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KIRWIN",
        "first_name": "JON",
        "middle_name": "DAVID",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-03-08",
        "last_updated": "2008-03-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2086S0129X",
            "taxonomy_group": "",
            "desc": "Surgery, Vascular Surgery",
            "state": "NY",
            "license": "160062",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01557735",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Brooklyn, NY

Sources for this page

Verify at the official NPI Registry.