NPIMap

Organization Active NPI

Mind Wellness Professional Psychiatric Services PC

  • Neurology Physician
  • Brooklyn, NY
National Provider Identifier
1265671184
Registry record updated May 23, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neurology PhysicianTaxonomy code 2084N0400X
License
249211 Issued in NY
Legal business name
MIND WELLNESS PROFESSIONAL PSYCHIATRIC SERVICES PC
Practice address
6903 4TH Ave
Brooklyn, NY 11209-1509
Phone
(718) 238-6161
NPI assigned
Feb 17, 2009
Last updated
May 23, 2017By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 23, 2017

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

Authorized official

Name
Dr. Ashraf ElshafeiNPI 1083816755
Title
Physician
Phone
(718) 238-6161

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
Neurology Physician 2084N0400X 249211 NY Primary

Addresses

Primary practice location

6903 4TH Ave
Brooklyn, NY 11209-1509

Mailing address

6903 4TH Ave
Brooklyn, NY 11209-1509
Phone (718) 238-6161

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20090228000039 NY Part B Supplier - Clinic/Group Practice 3375609258 Receives reassigned benefits from 13 practitioners
Practice locations: Astoria, NY; Brooklyn, NY

National Provider Directory

National Provider Directory

Locations

3272 Steinway St
Fl 5
Astoria, NY 11103
Phone (718) 204-9720

Practitioners & affiliated clinicians

Practitioners 17

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 17

NPI Registry JSON

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

{
    "created_epoch": "1234828800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1495497600000",
    "number": "1265671184",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6903 4TH AVE",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112091509",
            "telephone_number": "718-238-6161"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6903 4TH AVE",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112091509",
            "telephone_number": "718-238-6161"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MIND WELLNESS PROFESSIONAL PSYCHIATRIC SERVICES PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-02-17",
        "last_updated": "2017-05-23",
        "status": "A",
        "authorized_official_last_name": "ELSHAFEI",
        "authorized_official_first_name": "ASHRAF",
        "authorized_official_title_or_position": "PHYSICIAN",
        "authorized_official_telephone_number": "718-238-6161",
        "authorized_official_name_prefix": "Dr."
    },
    "taxonomies": [
        {
            "code": "2084N0400X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "NY",
            "license": "249211",
            "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 May 23, 2017; 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.