Active NPI
South Brooklyn Medical Administrative Services, Inc.
- Clinic/Center
- Brooklyn, NY
National Provider Identifier
1114093523
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinic/Center
- License
- 7001121R
- Legal business name
- SOUTH BROOKLYN MEDICAL ADMINISTRATIVE SERVICES, INC.
- Practice address
- 685 3Rd Ave
Brooklyn, NY 11232-1108 - Phone
- (718) 788-2594
- Fax
- (718) 788-5848
- NPI assigned
- Nov 28, 2006
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Alexis Bosco
- Title
- Administrative Director
- Phone
- (718) 788-2594
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinic/Center | 261Q00000X | 7001121R | NY | Primary |
Addresses
Primary practice location
685 3Rd Ave
Brooklyn, NY 11232-1108
Mailing address
685 3Rd Ave
Brooklyn, NY 11232-1108
Phone (718) 788-2594
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 02737286 | Medicaid | NY |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in NY
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20200106002218 | NY | Part B Supplier - Opioid Treatment Program (Otp) | 2466528856 | Practice locations: Brooklyn, NY |
Laboratory certificates & supplier records
Derived by NPIMapThese CMS records do not include an NPI. They are shown because their name and street address match this provider’s.
CLIA laboratory certificates
| CLIA number | Laboratory | Certificate | Expires |
|---|---|---|---|
| 33D1046907 | South Brooklyn Medical Administrative Services Inc | Certificate of waiver | Mar 26, 2027 |
National Provider Directory
National Provider DirectoryLocations
685 3rd Ave
Brooklyn, NY 11232
Phone (718) 788-2594
Practitioners & affiliated clinicians
Practitioners 1
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.
-
- Hematology & Oncology Physician
- Mount Kisco, NY
- NPI 1407883937
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1164672000000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1763596800000",
"number": "1114093523",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "685 3RD AVE",
"city": "BROOKLYN",
"state": "NY",
"postal_code": "112321108",
"telephone_number": "718-788-2594",
"fax_number": "347-529-4829"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "685 3RD AVE",
"city": "BROOKLYN",
"state": "NY",
"postal_code": "112321108",
"telephone_number": "718-788-2594",
"fax_number": "718-788-5848"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "SOUTH BROOKLYN MEDICAL ADMINISTRATIVE SERVICES, INC.",
"organizational_subpart": "NO",
"enumeration_date": "2006-11-28",
"last_updated": "2025-11-20",
"certification_date": "2025-11-20",
"status": "A",
"authorized_official_last_name": "BOSCO",
"authorized_official_first_name": "ALEXIS",
"authorized_official_title_or_position": "ADMINISTRATIVE DIRECTOR",
"authorized_official_telephone_number": "718-788-2594"
},
"taxonomies": [
{
"code": "261Q00000X",
"taxonomy_group": "",
"desc": "Clinic/Center",
"state": "NY",
"license": "7001121R",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "02737286",
"state": "NY"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Brooklyn, NY
- South Beach Psychiatric Center
- South Beach Psychiatric Center
- South Brooklyn Health
- South Brooklyn Health Center
- South Brooklyn Home Physical Therapy PLLC
- South Brooklyn Medical Care, PC
- South Brooklyn Medical PC
- South Brooklyn Medical Practice, PC
- South Brooklyn Nephrology Center Inc
- South Brooklyn Nephrology Center Inc
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 20, 2025; 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.