Organization Active NPI

Salut Medical PC

  • Geriatric Medicine (Family Medicine) Physician
  • Brooklyn, NY
National Provider Identifier
1245682475
Registry record updated Oct 16, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Geriatric Medicine (Family Medicine) PhysicianTaxonomy code 207QG0300X
License
215006 Issued in NY
Legal business name
SALUT MEDICAL PC
Practice address
699 Stanley Ave
Brooklyn, NY 11207-7905
Phone
(347) 689-8880
Fax
(718) 247-7382
NPI assigned
Jul 12, 2016
Last updated
Oct 16, 2016By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 16, 2016

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

Authorized official

Name
Ilya Kleyn, MDNPI 1851327092
Title
Owner
Phone
(347) 689-8880

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Geriatric Medicine (Family Medicine) PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207QG0300X 215006 NY Primary

Addresses

Primary practice location

699 Stanley Ave
Brooklyn, NY 11207-7905

Mailing address

1837 E 17TH St
Apt 5a
Brooklyn, NY 11229-2961
Phone (347) 689-8880

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20160930000262 NY Part B Supplier - Clinic/Group Practice 8820385107 Receives reassigned benefits from 3 practitioners
Practice locations: Brooklyn, NY

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 3

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": "1468281600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1476576000000",
    "number": "1245682475",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1837 E 17TH ST",
            "address_2": "APT 5A",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112292961",
            "telephone_number": "347-689-8880",
            "fax_number": "718-247-7382"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "699 STANLEY AVE",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112077905",
            "telephone_number": "347-689-8880",
            "fax_number": "718-247-7382"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SALUT MEDICAL PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-07-12",
        "last_updated": "2016-10-16",
        "status": "A",
        "authorized_official_last_name": "KLEYN",
        "authorized_official_first_name": "ILYA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "347-689-8880",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207QG0300X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine, Geriatric Medicine",
            "state": "NY",
            "license": "215006",
            "primary": true
        }
    ],
    "identifiers": [],
    "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 Oct 16, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.