Individual provider Active NPI

Kaulin Ervin, DO

  • Emergency Medicine Physician
  • Brooklyn, NY
National Provider Identifier
1255080073
Registry record updated Jun 2, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
OS21800 Issued in FL
Practice address
4802 10TH Ave
Brooklyn, NY 11219-2916
Phone
(718) 283-6000
NPI assigned
Mar 20, 2022
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 2, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X OS21800 FL Primary
Student in an Organized Health Care Education/Training Program 390200000X

Addresses

Primary practice location

4802 10TH Ave
Brooklyn, NY 11219-2916

Mailing address

4802 10TH Ave
Brooklyn, NY 11219-2916
Phone (718) 283-6000

Medicare participation

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

Enrollment IDStateProvider typePAC IDDetails
I20250617002358 FL Practitioner - Emergency Medicine 4284145111 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Emergency Medicine
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Synergy Medical Collective, PAGroup PAC ID 8628429958, 15 clinicians

Practice addresses (Care Compare)

2500 SW 75 Ave
Miami, FL 33155-2805
Phone (888) 537-2589

4300 Alton Rd
Miami, FL 33140-2948
Phone (305) 674-2064

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
OS21800FLMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Sterling Emergency Services of Miami Beach PA Emergency Medicine CurrentSince May 15, 2025 Accepting new patients
Sterling Emergency Services of Miami Beach PA Emergency Medicine CurrentSince May 15, 2025 Accepting new patients
Synergy Medical Collective, PA Emergency Medicine CurrentSince Aug 25, 2025 Accepting new patients

Locations

6050 W 20th Ave
Hialeah, FL 33016
Phone (786) 584-5000

2500 SW 75th Ave
Miami, FL 33155
Phone (305) 431-0577

2845 NE 199th St
Miami, FL 33180
Phone (305) 692-1000

4300 Alton Rd
Miami Beach, FL 33140
Phone (305) 481-9776

200 Corporate Blvd
Lafayette, LA 70508

Organizations & group practices 3

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.

Hospital & facility affiliations 2

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": "1647734400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1748822400000",
    "number": "1255080073",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4802 10TH AVE",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112192916",
            "telephone_number": "718-283-6000"
        },
        {
            "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": "718-283-6000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ERVIN",
        "first_name": "KAULIN",
        "name_prefix": "Dr.",
        "credential": "DO",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2022-03-20",
        "last_updated": "2025-06-02",
        "certification_date": "2025-06-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "FL",
            "license": "OS21800",
            "primary": true
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brooklyn, NY

Sources for this page

Verify at the official NPI Registry.