Organization Active NPI

Dr Gregory Shifrin OBGYN PC

  • Obstetrics & Gynecology Physician
  • Brooklyn, NY
National Provider Identifier
1154407013
Registry record updated Sep 27, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X
License
202259 Issued in NY
Legal business name
DR GREGORY SHIFRIN OBGYN PC
Practice address
1766 E 12TH Street
Brooklyn, NY 11229
Phone
(718) 743-0505
Fax
(718) 339-0760
NPI assigned
Oct 31, 2006
Last updated
Sep 27, 2013By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 27, 2013

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

Authorized official

Name
Mr. Gregory Shifrin, M.D.NPI 1477688604
Title
Owner
Phone
(718) 743-0505

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
Obstetrics & Gynecology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207V00000X 202259 NY Primary

Addresses

Primary practice location

1766 E 12TH Street
Brooklyn, NY 11229

Mailing address

1766 E 12TH Street
Brooklyn, NY 11229
Phone (718) 743-0505

Other identifiers 1

IdentifierTypeStateIssuer
01647410MedicaidNY

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20070423000525 NY Part B Supplier - Clinic/Group Practice 9830128271 Receives reassigned benefits from 9 practitioners
Practice locations: Brooklyn, NY; Bronx, NY; New York, NY

National Provider Directory

National Provider Directory

Locations

1766 E 12th St
Brooklyn, NY 11229
Phone (718) 375-2200

Practitioners & affiliated clinicians

Practitioners 11

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.

NPI Registry JSON

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

{
    "created_epoch": "1162252800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1380240000000",
    "number": "1154407013",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1766 E 12TH STREET",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "11229",
            "telephone_number": "718-743-0505",
            "fax_number": "718-339-0760"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1766 E 12TH STREET",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "11229",
            "telephone_number": "718-743-0505",
            "fax_number": "718-339-0760"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DR GREGORY SHIFRIN OBGYN PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-31",
        "last_updated": "2013-09-27",
        "status": "A",
        "authorized_official_last_name": "SHIFRIN",
        "authorized_official_first_name": "GREGORY",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "718-743-0505",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Obstetrics & Gynecology",
            "state": "NY",
            "license": "202259",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01647410",
            "state": "NY"
        }
    ],
    "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 Sep 27, 2013; 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.