NPIMap

Organization Active NPI

University Physicians of Brooklyn, Inc

Doing business as Downstate Health Physicians

  • Anesthesiology Physician
  • Brooklyn, NY
National Provider Identifier
1104878180
Registry record updated May 28, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
Legal business name
UNIVERSITY PHYSICIANS OF BROOKLYN, INC
Doing business as
Downstate Health Physicians
Practice address
450 Clarkson Ave
Brooklyn, NY 11203-2056
Phone
(718) 270-3083
Fax
(718) 270-3797
NPI assigned
May 17, 2006
Last updated
May 28, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 28, 2024

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

Authorized official

Name
Albert Guidice
Title
Enrollment Manager
Phone
(718) 613-8481

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology Physician 207L00000X NU Primary

Addresses

Primary practice location

450 Clarkson Ave
Brooklyn, NY 11203-2056

Mailing address

450 Clarkson Ave
MSC#80
Brooklyn, NY 11203-2056
Phone (718) 613-8481

Other identifiers 1

IdentifierTypeStateIssuer
02339568MedicaidNY

Other names 1

  • Downstate Health Physicians Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20031119000458 NY Part B Supplier - Clinic/Group Practice 0749192284 Receives reassigned benefits from 19 practitioners
Practice locations: Brooklyn, NY; Staten Island, NY
O20040401000120 NY Part B Supplier - Clinic/Group Practice 0749192284 Receives reassigned benefits from 285 practitioners
14 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Brooklyn, NY; Floral Park, NY; Monsey, NY; New York, NY; Rockaway Park, NY; Staten Island, NY; Belle Harbor, NY

Other NPIs with the same Medicare PAC ID 5

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

Other NPIs on the same Medicare enrollment 14

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

View all 14

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 220

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 220

NPI Registry JSON

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

{
    "created_epoch": "1147824000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1716854400000",
    "number": "1104878180",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "450 CLARKSON AVE",
            "address_2": "MSC#80",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112032056",
            "telephone_number": "718-613-8481",
            "fax_number": "718-613-8498"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "450 CLARKSON AVE",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112032056",
            "telephone_number": "718-270-3083",
            "fax_number": "718-270-3797"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "UNIVERSITY PHYSICIANS OF BROOKLYN, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-17",
        "last_updated": "2024-05-28",
        "certification_date": "2024-05-28",
        "status": "A",
        "authorized_official_last_name": "GUIDICE",
        "authorized_official_first_name": "ALBERT",
        "authorized_official_title_or_position": "ENROLLMENT MANAGER",
        "authorized_official_telephone_number": "718-613-8481"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02339568",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Downstate Health Physicians",
            "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 May 28, 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.