Organization Active NPI

Dr. Shtein Medical P.C.

  • Family Medicine Physician
  • Brooklyn, NY
National Provider Identifier
1114435765
Registry record updated Jan 17, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
259564 Issued in NY
Legal business name
DR. SHTEIN MEDICAL P.C.
Practice address
1068 Coney Island Ave
Brooklyn, NY 11230-2303
Phone
(718) 684-1760
NPI assigned
Jan 17, 2018
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 17, 2018

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

Authorized official

Name
Dr. Lyudmila Shtein, DONPI 1013297118
Title
DO
Phone
(718) 708-0875

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207Q00000X 259564 NY Primary

Addresses

Primary practice location

1068 Coney Island Ave
Brooklyn, NY 11230-2303

Mailing address

352 52ND St
Brooklyn, NY 11220-1810

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20180306000206 NY Part B Supplier - Clinic/Group Practice 9133480262 Receives reassigned benefits from 1 practitioner
Practice locations: Brooklyn, NY

Laboratory certificates & supplier records

Derived by NPIMap

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

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
33D2164465Dr Shtein Medical PC1068 Coney Island Avenue, Brooklyn, NY 11230Certificate of waiverApr 4, 2027

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1516147200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1516147200000",
    "number": "1114435765",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "352 52ND ST",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112201810"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1068 CONEY ISLAND AVE",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112302303",
            "telephone_number": "718-684-1760"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DR. SHTEIN MEDICAL P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-01-17",
        "last_updated": "2018-01-17",
        "status": "A",
        "authorized_official_last_name": "SHTEIN",
        "authorized_official_first_name": "LYUDMILA",
        "authorized_official_title_or_position": "DO",
        "authorized_official_telephone_number": "718-708-0875",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DO"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": "NY",
            "license": "259564",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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 Jan 17, 2018; 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.