Individual provider Active NPI

Kenneth S Felder, M.D.

  • Specialist
  • Brooklyn, NY
National Provider Identifier
1316910219
Registry record updated Jan 27, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
131057 Issued in NY
Practice address
2035 Ralph Ave
Suite A6
Brooklyn, NY 11234-5300
Phone
(718) 209-0101
Fax
(718) 209-0194
NPI assigned
Feb 10, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 27, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X 131057 NY Primary

Addresses

Primary practice location

2035 Ralph Ave
Suite A6
Brooklyn, NY 11234-5300

Mailing address

2035 Ralph Ave
Suite A6
Brooklyn, NY 11234
Phone (718) 209-0101

Other identifiers 1

IdentifierTypeStateIssuer
00717208MedicaidNY

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

NPI Registry JSON

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

{
    "created_epoch": "1139529600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1264550400000",
    "number": "1316910219",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2035 RALPH AVE",
            "address_2": "SUITE A6",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "11234",
            "telephone_number": "718-209-0101",
            "fax_number": "718-209-0194"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2035 RALPH AVE",
            "address_2": "SUITE A6",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112345300",
            "telephone_number": "718-209-0101",
            "fax_number": "718-209-0194"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FELDER",
        "first_name": "KENNETH",
        "middle_name": "S",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-02-10",
        "last_updated": "2010-01-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "NY",
            "license": "131057",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00717208",
            "state": "NY"
        }
    ],
    "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 Jan 27, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.