NPIMap

Individual provider Active NPI

Kevin Tin, M.D.

  • Gastroenterology Physician
  • Brooklyn, NY
National Provider Identifier
1174812044
Registry record updated Dec 9, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gastroenterology PhysicianTaxonomy code 207RG0100X
License
275612 Issued in NY
Practice address
902 Quentin Rd Ste 701
Brooklyn, NY 11223
Phone
(718) 336-3900
Fax
(718) 336-3990
NPI assigned
Mar 31, 2011
Last updated
Dec 9, 2019By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 9, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Gastroenterology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207RG0100X 275612 NY Primary

Addresses

Primary practice location

902 Quentin Rd Ste 701
Brooklyn, NY 11223

Mailing address

PO Box 205318
Brooklyn, NY 11220-7318
Phone (347) 256-6739

Other practice location 1

4802 10th Avenue
Maimonides Medical Center
Brooklyn, NY 11219
Phone (718) 283-6000

Other practice location 2

4802 10th Avenue
Maimonides Medical Center
Brooklyn, NY 11219
Phone (718) 283-6000

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20150312001295 NY Practitioner - GastroenterologyPractitioner - Internal Medicine 9830415728 Reassigns benefits to 10 organizations
Practice locations: Brooklyn, NY

Care Compare profile

Medicare Care Compare
Specialty
Gastroenterology
Education
Other, 2011
Medicare assignment
May accept Medicare assignment
Group practices
East Summit Medical PCGroup PAC ID 7618205618, 2 clinicians
Boro Park Operating Co LLCGroup PAC ID 3577751320, 7 clinicians
East Point Medical PCGroup PAC ID 0749690741, 24 clinicians
Newtown Gastroenterology PCGroup PAC ID 4587044375, 12 clinicians

Practice addresses (Care Compare)

1577 Fulton St
Brooklyn, NY 11213-1125
Phone (718) 307-1577

4915 10TH Ave
Brooklyn, NY 11219-3301
Phone (718) 851-3700

6219 5TH Ave
Brooklyn, NY 11220-4611
Phone (718) 307-1577

822 57TH St
Apt 1
Brooklyn, NY 11220-5196
Phone (917) 398-2588

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Colonoscopy12
Upper gastrointestinal (GI) endoscopy for acid reflux27

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Maimonides Medical Center Maimonides Primary Care FPP Single Specialty CurrentSince Jul 1, 2014 Accepting new patients
Maimonides Faculty Practice Plan Single Specialty CurrentSince Dec 6, 2017 Accepting new patients
East Summit Medical PC Single Specialty CurrentSince Jul 15, 2019 Accepting new patients
Maimonides Medical Center Current Accepting new patients
Newtown Gastroenterology PC Single Specialty CurrentSince Mar 25, 2022 Accepting new patients
Boro Park Operating Co LLC Single Specialty CurrentSince Mar 1, 2015 Accepting new patients
East Point Medical PC Single Specialty CurrentSince Sep 11, 2020 Accepting new patients
Amb Medical Services, P.C. Single Specialty CurrentSince Apr 1, 2022 Accepting new patients
Gastroenterology Associates of Brooklyn PLLC Single Specialty CurrentSince Jun 10, 2018 Accepting new patients
Ion Oltean Physician PC Single Specialty CurrentSince Jan 1, 2016 Accepting new patients
Maimonides Medical Center - MMC Gastroenterology FPP Single Specialty CurrentSince Jul 1, 2018 Accepting new patients
Good Health Psychiatric Services PC Single Specialty PastSince Oct 22, 2022 Accepting new patients
New Day Medical PC Single Specialty Past Accepting new patients
MK Anesthesia Services PLLC Single Specialty PastSince Dec 1, 2021 Accepting new patients
Boro Park Operating Co LLC Past Accepting new patients

Locations

1577 Fulton St
Brooklyn, NY 11213
Phone (347) 915-1411

26 Court St
Ste 808
Brooklyn, NY 11242
Phone (718) 307-1577

4802 10th Ave
Brooklyn, NY 11219
Phone (718) 283-8724

4915 10th Ave
Brooklyn, NY 11219
Phone (718) 851-3700

6219 5th Ave
Brooklyn, NY 11220
Phone (718) 307-1577

691 92nd St
Brooklyn, NY 11228
Phone (718) 567-1000

902 Quentin Rd
Fl 7
Brooklyn, NY 11223
Phone (718) 336-3900

902 Quentin Rd
Ste 701
Brooklyn, NY 11223
Phone (718) 336-3900

3515 Parsons Blvd
Flushing, NY 11354
Phone (718) 961-3500

3617 Parsons Blvd
Flushing, NY 11354
Phone (718) 888-5200

3712 Prince St
Ste 5D
Flushing, NY 11354
Phone (718) 368-6180

7116 Grand Ave
Maspeth, NY 11378
Phone (718) 307-1577

40 Bowery
New York, NY 10013

6655 Fresh Pond Rd
Ridgewood, NY 11385
Phone (718) 497-1919

Networks

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

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/IEGGCA
  • Direct secure messaging: kevintin@mai.allscriptsdirect.net
  • Direct secure messaging: ktin65553@northwell.direct-ci.com

Organizations & group practices 15

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

View all 15

Hospital & facility affiliations 8

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": "1301529600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1575849600000",
    "number": "1174812044",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 205318",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112207318",
            "telephone_number": "347-256-6739",
            "fax_number": "949-404-6857"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "902 QUENTIN RD STE 701",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "11223",
            "telephone_number": "718-336-3900",
            "fax_number": "718-336-3990"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4802 10th Avenue",
            "address_2": "Maimonides Medical Center",
            "address_purpose": "LOCATION",
            "city": "Brooklyn",
            "state": "NY",
            "postal_code": "11219",
            "country_code": "US",
            "telephone_number": "718-283-6000",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "4802 10th Avenue",
            "address_2": "Maimonides Medical Center",
            "address_purpose": "LOCATION",
            "city": "Brooklyn",
            "state": "NY",
            "postal_code": "11219",
            "country_code": "US",
            "telephone_number": "718-283-6000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "TIN",
        "first_name": "KEVIN",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2011-03-31",
        "last_updated": "2019-12-09",
        "certification_date": "2019-12-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RG0100X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "NY",
            "license": "275612",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brooklyn, NY

Sources for this page

Verify at the official NPI Registry.