NPIMap

Organization Active NPI

MMC OB GYN Perinatal Diagnostic Ultrasound

  • Obstetrics & Gynecology Physician
  • Brooklyn, NY
National Provider Identifier
1326045477
Registry record updated Jan 18, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X
Legal business name
MMC OB GYN PERINATAL DIAGNOSTIC ULTRASOUND
Practice address
5014 Fort Hamilton Parkway
Brooklyn, NY 11234
Phone
(718) 283-8941
Fax
(718) 635-8977
NPI assigned
Jul 5, 2005
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 18, 2022

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

Authorized official

Name
Shoshana Haberman, MDNPI 1447250980
Title
Director
Phone
(718) 283-8943

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 2

Specialty (taxonomy)CodeLicenseStatePrimary
SpecialistGroup: 193200000X MULTI-SPECIALTY GROUP 174400000X
Obstetrics & Gynecology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207V00000X Primary

Addresses

Primary practice location

5014 Fort Hamilton Parkway
Brooklyn, NY 11234

Mailing address

5014 Fort Hamilton Parkway
Brooklyn, NY 11234
Phone (718) 283-8941

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20110421000177 NY Part B Supplier - Clinic/Group Practice 1052596889 Receives reassigned benefits from 9 practitioners
Practice locations: Brooklyn, NY

National Provider Directory

National Provider Directory

Locations

5014 Fort Hamilton Pkwy
Brooklyn, NY 11219
Phone (718) 283-7979

4813 9th Ave
Ste 4
Brooklyn, NY 11220

4813 9th Ave
#4
Brooklyn, NY 11220

26 Court St
Ste 11
Brooklyn, NY 11242

Practitioners & affiliated clinicians

Practitioners 12

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": "1120521600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1642464000000",
    "number": "1326045477",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5014 FORT HAMILTON PARKWAY",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "11234",
            "telephone_number": "718-283-8941",
            "fax_number": "718-635-8977"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5014 FORT HAMILTON PARKWAY",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "11234",
            "telephone_number": "718-283-8941",
            "fax_number": "718-635-8977"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MMC OB GYN PERINATAL DIAGNOSTIC ULTRASOUND",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-07-05",
        "last_updated": "2022-01-18",
        "certification_date": "2022-01-18",
        "status": "A",
        "authorized_official_last_name": "HABERMAN",
        "authorized_official_first_name": "SHOSHANA",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "718-283-8943",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Specialist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207V00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Obstetrics & Gynecology",
            "state": null,
            "license": null,
            "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 Jan 18, 2022; 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.