Individual provider Active NPI

Craig Passmore

  • Anesthesiology Physician
  • Brooklyn, NY
National Provider Identifier
1124046255
Registry record updated Feb 26, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
License
196992 Issued in NY
Practice address
121 Dekalb Ave
Brooklyn, NY 11201-5425
Phone
(718) 250-8848
Fax
(718) 250-8850
NPI assigned
Jul 17, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 26, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X 196992 NY
Anesthesiology Physician 207L00000X 196992 NY Primary

Addresses

Primary practice location

121 Dekalb Ave
Brooklyn, NY 11201-5425

Mailing address

121 Dekalb Ave
Brooklyn, NY 11201-5425
Phone (718) 250-8848

Other identifiers 1

IdentifierTypeStateIssuer
01828564MedicaidNY

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
I20071112000410 NY Practitioner - Anesthesiology 2466550876 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Anesthesiology
Education
State University of Ny Upstate Medical University, 1992
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Jamaica Anesthesiologist PCGroup PAC ID 1355323460, 80 clinicians

Practice addresses (Care Compare)

8900 Van Wyck Expy
Jamaica, NY 11418-2832
Phone (718) 206-6088

Hospital & facility affiliations

  • Jamaica Hospital Medical Center Hospital, Jamaica, NY, CCN 330014

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
196992NYMDAnesthesiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Jamaica Anesthesiologist, PC Anesthesiology CurrentSince Feb 17, 2010 Accepting new patients
TBHC Anesthesiology Services, PC Specialist Past Accepting new patients
CMC Radiological Services PC Past Accepting new patients
Judah Schorr MD PC Anesthesiology Past Accepting new patients
Boulevard Anesthesia Associates, PC Anesthesiology Past Accepting new patients
Saint Vincents Catholic Medical Centers of New York Past Accepting new patients

Locations

8900 Van Wyck Expy
Richmond Hill, NY 11418
Phone (718) 206-6088

Networks

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

Organizations & group practices 6

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 1

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": "1153094400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1708905600000",
    "number": "1124046255",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "121 DEKALB AVE",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112015425",
            "telephone_number": "718-250-8848",
            "fax_number": "718-250-8850"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "121 DEKALB AVE",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112015425",
            "telephone_number": "718-250-8848",
            "fax_number": "718-250-8850"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PASSMORE",
        "first_name": "CRAIG",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-07-17",
        "last_updated": "2024-02-26",
        "certification_date": "2024-02-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "NY",
            "license": "196992",
            "primary": false
        },
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "NY",
            "license": "196992",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01828564",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Brooklyn, NY

Sources for this page

Verify at the official NPI Registry.