Organization Active NPI

Jeffrey L. Teitelbaum, MD PC

  • Internal Medicine Physician
  • Brooklyn, NY
National Provider Identifier
1306937347
Registry record updated May 5, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
188400 Issued in NY
Legal business name
JEFFREY L. TEITELBAUM, MD PC
Practice address
913 Avenue L
Brooklyn, NY 11230-4707
Phone
(718) 859-8391
NPI assigned
Sep 27, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 5, 2023

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

Authorized official

Name
Miss Malky Tenenbaum
Title
Office Manager
Phone
(718) 859-8391

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207R00000X 188400 NY Primary
Pediatrics PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 208000000X 188400 NY

Addresses

Primary practice location

913 Avenue L
Brooklyn, NY 11230-4707

Mailing address

913 Avenue L
Brooklyn, NY 11230-4707
Phone (718) 859-8391

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20070320000639 NY Part B Supplier - Clinic/Group Practice 6002919602 Receives reassigned benefits from 1 practitioner
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
33D1052244Jeffrey L Teitelbaum MD PC913 Avenue L, Ground Level, Brooklyn, NY 11230ComplianceDec 18, 2026

National Provider Directory

National Provider Directory

Locations

913 Avenue L
Brooklyn, NY 11230
Phone (718) 859-8391

Practitioners & affiliated clinicians

Practitioners 5

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1159315200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1683244800000",
    "number": "1306937347",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "913 AVENUE L",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112304707",
            "telephone_number": "718-859-8391"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "913 AVENUE L",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112304707",
            "telephone_number": "718-859-8391"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JEFFREY L. TEITELBAUM, MD PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-27",
        "last_updated": "2023-05-05",
        "certification_date": "2023-05-05",
        "status": "A",
        "authorized_official_last_name": "TENENBAUM",
        "authorized_official_first_name": "MALKY",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "718-859-8391",
        "authorized_official_name_prefix": "Miss"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine",
            "state": "NY",
            "license": "188400",
            "primary": true
        },
        {
            "code": "208000000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Pediatrics",
            "state": "NY",
            "license": "188400",
            "primary": false
        }
    ],
    "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 5, 2023; 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.