NPIMap

Organization Active NPI

New York Community Hospital of Brooklyn Inc

  • General Acute Care Hospital
  • Brooklyn, NY
National Provider Identifier
1215030697
Registry record updated Mar 17, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Acute Care HospitalTaxonomy code 282N00000X
Legal business name
NEW YORK COMMUNITY HOSPITAL OF BROOKLYN INC
Practice address
2525 Kings Hwy
Brooklyn, NY 11229-1705
Phone
(518) 299-1667
Fax
(718) 692-5309
NPI assigned
Sep 7, 2006
Last updated
Mar 17, 2022By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 17, 2022

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

Authorized official

Name
Julius Derdik
Title
Cao
Phone
(518) 284-8237

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Acute Care Hospital 282N00000X Primary

Addresses

Primary practice location

2525 Kings Hwy
Brooklyn, NY 11229-1705

Mailing address

2525 Kings Hwy
Brooklyn, NY 11229-1705
Phone (518) 299-1667

Other identifiers 2

IdentifierTypeStateIssuer
000076OtherNYEBCBS
00243696MedicaidNY

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY3 enrollments

Enrollment records 3

Enrollment IDStateProvider typePAC IDDetails
O20110309000874 NY Part A Provider - Hospital 6901798016 Practice locations: Brooklyn, NY
O20180417000319 NY Part B Supplier - Hospital Department(S) 6901798016 Receives reassigned benefits from 53 practitioners
1 other NPI on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Brooklyn, NY
O20230130000354 NY Part B Supplier - Clinic/Group Practice 6901798016 Receives reassigned benefits from 14 practitioners
Practice locations: Brooklyn, NY

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1215030697. Details of each certification follow.

Hospital certification: CCN 330019

Legal name
NEW YORK COMMUNITY HOSPITAL OF BROOKLYN INC
Doing business as
NEW YORK COMMUNITY HOSPITAL
Certification status
Active
Provider type (POS)
Hospital – Short-term
Participating since
Jul 1, 1966
Last certification
Apr 25, 2025
Beds
134
Ownership / control type
Private (not for profit)
Organization structure
CorporationNon-profit
Incorporated
Aug 27, 1945 in NY
Enrollment address
2525 Kings Hwy
Brooklyn, NY 11229-1705
Main/Primary Hospital Location
Hospital subgroups
Acute care

Other NPIs with the same Medicare PAC ID 1

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

Other NPIs on the same Medicare enrollment 1

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

Care Compare: Hospital

Medicare Care Compare
Listed as
New York Community Hospital of Brooklyn, Inc.CCN 330019 · All quality measures
Overall star rating
1 of 5
Type
Acute Care Hospitals
Ownership
Voluntary non-profit - Private
Medicare certification status
ActiveFrom the Provider of Services file
Emergency services
Yes

National Provider Directory

National Provider Directory

Member of 1

Organizations this organization is a member of, according to the National Provider Directory.

Locations

333 Jericho Tpke
Ste 102
Jericho, NY 11753
Phone (516) 937-9100

Ownership & related parties

All disclosed owners & managing parties 37

As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.

NameRoleSinceShare
David Spira Individual Corporate Director Jun 29, 2021
Aaron D Twerski Individual Corporate Director Jun 29, 2021
Paul Addison Individual Corporate Director Jun 29, 2021
Joseph F. Bruno Individual Corporate Director Jun 29, 2021
Laurie E Weinstein Individual Corporate Director Jun 29, 2021
Frank Naccarato Individual Corporate Director Jun 29, 2021
Richard D Forman Individual Corporate Director Jun 29, 2021
Jack a Hidary Individual Corporate Director Jun 29, 2021
Alexander Rovt Individual Corporate Director Jun 29, 2021
Kenneth D Gibbs Individual Corporate Director Jun 29, 2021
Chaim H Leshkowitz Individual Corporate Director Jun 29, 2021
Mary G. Singh Individual Corporate Director Jun 29, 2021
Lofton P. Holder Individual Corporate Director Jun 29, 2021
Trevor Price Individual Corporate Director Jun 29, 2021
Robert Ren Individual Contracted Managing EmployeeChief Administrative Officer Apr 4, 2022
Corporate DirectorChief Administrative Officer Apr 4, 2022
Jeremy M. Glick Individual Corporate Director Jun 29, 2021
Julius Derdik Individual Corporate OfficerSpecial Advisor to the Ceo Apr 1, 2001
Harold L Adler Individual Corporate Director Jun 29, 2021
George Weinberger Individual Corporate Officer Aug 1, 1989
Corporate Director Jun 29, 2021
Donna J Astion Individual Corporate Director Jun 29, 2021
Richard Barasch Individual Corporate Director Jun 29, 2021
Mortimer N Klaus Individual Corporate Director Jun 29, 2021
Maimonides Health Resources Inc Organization, Brooklyn, NY Corporation, For-profit 5% Or Greater Indirect Ownership Interest Jun 29, 2021 100%
Donald Meltzer Individual Corporate Director Jun 29, 2021
Robert B Machinist Individual Corporate Director Jun 29, 2021
Peter E Rebenwurzel Individual Corporate Director Jun 29, 2021
Azzam R. Obeid Individual Corporate Director Jun 29, 2021
George C.K. Liu Individual Corporate Director Jun 29, 2021
Chaim Fischer Individual Corporate Director Jun 29, 2021
Barry W Stern Individual Corporate Officer Feb 18, 2014
Erminia Rivera Individual Corporate Director Jun 29, 2021
Eugene Keilin Individual Corporate Director Jun 29, 2021
Martin D Payson Individual Corporate Director Jun 29, 2021
Irene Delizzo Individual Corporate Officer Sep 1, 2012
Maimonides Medical Center Organization, Brooklyn, NY Corporation, Non-profit 5% Or Greater Direct Ownership Interest Jun 29, 2021 100%
Michael L Ziegler Individual Corporate Director Jun 29, 2021
David M Cassato Individual Corporate Director Jun 29, 2021

Owners & managing parties with NPI records 6

Owners and managing parties disclosed on this facility’s Medicare enrollment that are themselves Medicare-enrolled.

Facilities with the same owner 1

Facilities that share an organizational owner with 5% or greater ownership or operational control.

Practitioners & affiliated clinicians

Practitioners 57

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.

View all 57

Affiliated clinicians 244

Clinicians who list this facility as an affiliation in Medicare Care Compare.

View all 244

NPI Registry JSON

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

{
    "created_epoch": "1157587200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1647475200000",
    "number": "1215030697",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2525 KINGS HWY",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112291705",
            "telephone_number": "518-299-1667",
            "fax_number": "718-692-5309"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2525 KINGS HWY",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112291705",
            "telephone_number": "518-299-1667",
            "fax_number": "718-692-5309"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NEW YORK COMMUNITY HOSPITAL OF BROOKLYN INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-07",
        "last_updated": "2022-03-17",
        "certification_date": "2022-03-17",
        "status": "A",
        "authorized_official_last_name": "DERDIK",
        "authorized_official_first_name": "JULIUS",
        "authorized_official_title_or_position": "CAO",
        "authorized_official_telephone_number": "518-284-8237"
    },
    "taxonomies": [
        {
            "code": "282N00000X",
            "taxonomy_group": "",
            "desc": "General Acute Care Hospital",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "EBCBS",
            "identifier": "000076",
            "state": "NY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00243696",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Brooklyn, NY

Sources for this page

Verify at the official NPI Registry.