Active NPI
Owen Fitzpatrick Ifill, MD
- Internal Medicine Physician
- Brooklyn, NY
National Provider Identifier
1275585580
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Internal Medicine Physician
- License
- 214819-1
- Practice address
- 937 Fulton St
Brooklyn, NY 11238-2347 - Phone
- (718) 789-2540
- Fax
- (718) 230-3052
- NPI assigned
- May 16, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Internal Medicine Physician | 207R00000X | 214819-1 | NY | Primary |
Addresses
Primary practice location
937 Fulton St
Brooklyn, NY 11238-2347
Mailing address
22 Chapel St
Brooklyn, NY 11201-1903
Phone (718) 260-2962
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 214819-1 | NY | MD | Internal Medicine Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1147737600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1202083200000",
"number": "1275585580",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "22 CHAPEL ST",
"city": "BROOKLYN",
"state": "NY",
"postal_code": "112011903",
"telephone_number": "718-260-2962",
"fax_number": "718-522-3186"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "937 FULTON ST",
"city": "BROOKLYN",
"state": "NY",
"postal_code": "112382347",
"telephone_number": "718-789-2540",
"fax_number": "718-230-3052"
}
],
"practiceLocations": [],
"basic": {
"last_name": "IFILL",
"first_name": "OWEN",
"middle_name": "FITZPATRICK",
"name_prefix": "Dr.",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-05-16",
"last_updated": "2008-02-04",
"status": "A"
},
"taxonomies": [
{
"code": "207R00000X",
"taxonomy_group": "",
"desc": "Internal Medicine",
"state": "NY",
"license": "214819-1",
"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 Feb 4, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.