Organization Active NPI

Mountview Medical PC

  • Neurology Physician
  • Brooklyn, NY
National Provider Identifier
1124593082
Registry record updated Oct 8, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neurology PhysicianTaxonomy code 2084N0400X
Legal business name
MOUNTVIEW MEDICAL PC
Practice address
829 57TH St # 5
Brooklyn, NY 11220-3677
Phone
(718) 964-3930
NPI assigned
Oct 8, 2018
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 8, 2018

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

Authorized official

Name
Mellissa Gu
Title
Manager
Phone
(718) 964-3930

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Neurology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 2084N0400X Primary

Addresses

Primary practice location

829 57TH St # 5
Brooklyn, NY 11220-3677

Mailing address

829 57TH St # 5
Brooklyn, NY 11220-3677
Phone (718) 964-3930

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20190115000405 NY Part B Supplier - Clinic/Group Practice 0749526648 Receives reassigned benefits from 1 practitioner
Practice locations: Brooklyn, NY

National Provider Directory

National Provider Directory

Locations

829 57th St
#5
Brooklyn, NY 11220
Phone (718) 375-3738

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": "1538956800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1538956800000",
    "number": "1124593082",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "829 57TH ST # 5",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112203677",
            "telephone_number": "718-964-3930"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "829 57TH ST # 5",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112203677",
            "telephone_number": "718-964-3930"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MOUNTVIEW MEDICAL PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-10-08",
        "last_updated": "2018-10-08",
        "status": "A",
        "authorized_official_last_name": "GU",
        "authorized_official_first_name": "MELLISSA",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "718-964-3930"
    },
    "taxonomies": [
        {
            "code": "2084N0400X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": null,
            "license": null,
            "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 Oct 8, 2018; 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.