Maimonides Paramedic Ambulance
Organization Active NPI Emergency Medicine Physician · Brooklyn, NY
NPI 1174637490 · NPPES record last updated Aug 22, 2020
Key facts
- NPI
- 1174637490
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Emergency Medicine Physician 207P00000X
- Legal business name
- MAIMONIDES PARAMEDIC AMBULANCE
- Practice address
- 4802 10TH Ave
Brooklyn, NY 11219-2916 - Phone
- (718) 283-8773
- NPI assigned
- Aug 17, 2006
- Organization subpart
- No
Authorized official
- Name
- Dr. Steven Davidson, MD
- Title
- Department Chairman
- Phone
- (718) 283-8773
Owned or controlled facilities with NPI records 1
Other NPIs with the same Medicare PAC ID 2
Corporate family (same tax ID) 26
Member organizations 6
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in NY
All facility ownership & control disclosures 1
| Facility | Type | Role | Since |
|---|---|---|---|
| New York Community Hospital |
Hospital | 5% Or Greater Direct Ownership Interest (100%) | Jun 29, 2021 |
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20120522001017 | NY | Part B Supplier - Ambulance Service Supplier | 9234111998 | Practice locations: Brooklyn, NY |
National Provider Directory
- Tax ID family
- New York Vascular Care PL
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Emergency Medicine Physician |
207P00000X | Yes |
Addresses
Primary practice location
4802 10TH Ave
Brooklyn, NY 11219-2916
Mailing address
PO Box 283
Brooklyn, NY 11220-0283
Phone (718) 283-8773
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 01079996 | Medicaid | NY |
NPI Registry JSON
{
"created_epoch": "1155772800000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1598054400000",
"number": "1174637490",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 283",
"city": "BROOKLYN",
"state": "NY",
"postal_code": "112200283",
"telephone_number": "718-283-8773"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4802 10TH AVE",
"city": "BROOKLYN",
"state": "NY",
"postal_code": "112192916",
"telephone_number": "718-283-8773"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "MAIMONIDES PARAMEDIC AMBULANCE",
"organizational_subpart": "NO",
"enumeration_date": "2006-08-17",
"last_updated": "2020-08-22",
"status": "A",
"authorized_official_last_name": "DAVIDSON",
"authorized_official_first_name": "STEVEN",
"authorized_official_title_or_position": "DEPARTMENT CHAIRMAN",
"authorized_official_telephone_number": "718-283-8773",
"authorized_official_name_prefix": "Dr.",
"authorized_official_credential": "MD"
},
"taxonomies": [
{
"code": "207P00000X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Emergency Medicine",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "01079996",
"state": "NY"
}
],
"endpoints": [],
"other_names": []
}Other providers in Brooklyn, NY
- Maimonides Medical Center-MMC Midwifery
- Maimonides Medical Ctr Department of Pediatrics
- Maimonides Nursery FPP
- Maimonides OB GYN
- Maimonides Pain Management FPP
- Maimonides Paramedic Ambulance
- Maimonides Pulmonary FPP
- Maimonides RX Inc
- Maimonides Urology FPP
- Maimonidesmedicalcenter
All providers in Brooklyn, NY · Emergency Medicine Physician in New York
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 22, 2020. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- CMS facility enrollments, All Owners and change-of-ownership files: CCNs, owners and managing parties.
- Provider of Services files (CMS): certification status, beds and related CCNs.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.