Organization Active NPI

Elnunu Medical PC

  • Pediatrics Physician
  • Brooklyn, NY
National Provider Identifier
1235470238
Registry record updated Mar 15, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
249440-1 Issued in NY
Legal business name
ELNUNU MEDICAL PC
Practice address
2311 Coney Island Ave
Brooklyn, NY 11223-3337
Phone
(646) 872-6818
NPI assigned
Mar 15, 2013
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 15, 2013

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

Authorized official

Name
Linda BanbahjiNPI 1114363595
Title
Manager
Phone
(646) 872-6818

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 208000000X 249440-1 NY Primary

Addresses

Primary practice location

2311 Coney Island Ave
Brooklyn, NY 11223-3337

Mailing address

2311 Coney Island Ave
Brooklyn, NY 11223-3337
Phone (646) 872-6818

Other identifiers 1

IdentifierTypeStateIssuer
249440-1OtherNYLICENSE#

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20230206000106 NY Part B Supplier - Clinic/Group Practice 3375915127 Receives reassigned benefits from 3 practitioners
Practice locations: Brooklyn, NY

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
33D2277622Elnunu Medical PC2311 Coney Island Avenue, Brooklyn, NY 11223Certificate of waiverMar 1, 2027

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 6

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": "1363305600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1363305600000",
    "number": "1235470238",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2311 CONEY ISLAND AVE",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112233337",
            "telephone_number": "646-872-6818"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2311 CONEY ISLAND AVE",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112233337",
            "telephone_number": "646-872-6818"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ELNUNU MEDICAL PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-03-15",
        "last_updated": "2013-03-15",
        "status": "A",
        "authorized_official_last_name": "BANBAHJI",
        "authorized_official_first_name": "LINDA",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "646-872-6818"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Pediatrics",
            "state": "NY",
            "license": "249440-1",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE#",
            "identifier": "249440-1",
            "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 Mar 15, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.