Individual provider Active NPI

Sam Katzurin, M.D.

  • Ophthalmology Physician
  • Brooklyn, NY
National Provider Identifier
1306967211
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ophthalmology PhysicianTaxonomy code 207W00000X
License
131528 Issued in NY
Practice address
161 Atlantic Ave
Suite 203
Brooklyn, NY 11201-6720
Phone
(718) 852-5232
Fax
(718) 596-9085
NPI assigned
Apr 2, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Ophthalmology Physician 207W00000X 131528 NY Primary

Addresses

Primary practice location

161 Atlantic Ave
Suite 203
Brooklyn, NY 11201-6720

Mailing address

11 Stony Run Rd
Great Neck, NY 11023-1923
Phone (516) 829-6449

Other identifiers 1

IdentifierTypeStateIssuer
00374552MedicaidNY

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
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
I20110310000637 NY Practitioner - Ophthalmology 9234311317 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Ophthalmology
Education
Other, 1973
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

161 Atlantic Ave
Suite 203
Brooklyn, NY 11201-6720
Phone (718) 852-5232

5606 15TH Ave
Brooklyn, NY 11219-4708
Phone (718) 474-6400

Merit-based Incentive Payment System (MIPS)

Final score
0 of 100Reported as individual
Quality
0
Improvement activities
0
Cost
0

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Sam Katzurin MD PC Ophthalmology CurrentSince Jul 1, 1977 Accepting new patients

Locations

161 Atlantic Ave
Ste 203
Brooklyn, NY 11201
Phone (718) 596-1389

2720 Surf Ave
Brooklyn, NY 11224
Phone (718) 230-4844

155 Dean St
Brooklyn, NY 11217
Phone (718) 694-6700

300 Madison St
Brooklyn, NY 11216
Phone (718) 250-6100

1485 Dumont Ave
Brooklyn, NY 11208
Phone (718) 521-4442

339 Hicks St
Brooklyn Heights, NY 11201
Phone (718) 780-1538

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1175472000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1306967211",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11 STONY RUN RD",
            "city": "GREAT NECK",
            "state": "NY",
            "postal_code": "110231923",
            "telephone_number": "516-829-6449",
            "fax_number": "516-829-2539"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "161 ATLANTIC AVE",
            "address_2": "SUITE 203",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112016720",
            "telephone_number": "718-852-5232",
            "fax_number": "718-596-9085"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KATZURIN",
        "first_name": "SAM",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-04-02",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "NY",
            "license": "131528",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00374552",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Brooklyn, NY

Sources for this page

Verify at the official NPI Registry.