Eitan Dickman, M.D.

Primary specialty

Emergency Medical Services (Emergency Medicine) PhysicianTaxonomy code 207PE0004X

License

223623 Issued in NY

Practice address

4802 10TH Ave
Brooklyn, NY 11219-2916

Phone

(718) 283-6057

Fax

(718) 283-8713

NPI assigned

Nov 2, 2005

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in NY

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Networks

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

Interoperability endpoints

• Direct secure messaging: eitandickman@mai.allscriptsdirect.net

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

• Maimonides Faculty Practice Plan

  • Internal Medicine Physician
  • Brooklyn, NY
  • NPI 1053344846
  Medicare reassignment NPD
• Maimonides Medical Center - MMC Emergency Physicians FPP

  • Emergency Medicine Physician
  • Brooklyn, NY
  • NPI 1982708202
  Medicare reassignment NPD
• Maimonides Medical Center

  • General Acute Care Hospital
  • Brooklyn, NY
  • NPI 1093777492
  NPD
• Doctors for Emergency Service

  • Emergency Medicine Physician
  • Newark, DE
  • NPI 1750369674
  NPD (past)
• Umass Memorial Medical Group Inc

  • Internal Medicine Physician
  • Worcester, MA
  • NPI 1760445373
  NPD (past)

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

{
    "created_epoch": "1130889600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1248134400000",
    "number": "1225029861",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 29580",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100879580",
            "telephone_number": "718-283-6057",
            "fax_number": "718-283-8713"
        },
        {
            "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": "718-283-6057",
            "fax_number": "718-283-8713"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DICKMAN",
        "first_name": "EITAN",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-11-02",
        "last_updated": "2009-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207PE0004X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine, Emergency Medical Services",
            "state": "NY",
            "license": "223623",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02593406",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Nancy S Dickerson, RN
• Prunella Cynthia Dickerson
• Wesley J Dickerson, M.D.
• Thomas Jay Dickert, D.C.
• Nitasha Rae Dickes, BCBA, PLMHP
• Grace Dickman, LMSW, LCSW
• Ian Vebert Malvar Dickman
• John Andrew Dickman, LMSW
• Gwendolyn Dickson, LCSW
• Idongesit Dickson, OTR/L

• Emergency Medical Services (Emergency Medicine) Physician in Brooklyn, NY
• Providers in Brooklyn, NY by specialty
• Emergency Medical Services (Emergency Medicine) Physician in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.