NPIMap

Organization Active NPI

Brighton Medical Practice P.C.

  • Family Medicine Physician
  • Brooklyn, NY
National Provider Identifier
1346883774
Registry record updated Apr 14, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
BRIGHTON MEDICAL PRACTICE P.C.
Practice address
706 Banner Ave
Brooklyn, NY 11235-6957
Phone
(718) 368-3092
Fax
(718) 368-2051
NPI assigned
Oct 17, 2019
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 14, 2021

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

Authorized official

Name
Shila Momtaj
Title
Manager
Phone
(718) 368-3092

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207Q00000X Primary

Addresses

Primary practice location

706 Banner Ave
Brooklyn, NY 11235-6957

Mailing address

706 Banner Ave
Brooklyn, NY 11235-6957
Phone (718) 368-3092

Other identifiers 1

IdentifierTypeStateIssuer
02743364MedicaidNY

Electronic endpoints 1

TypeEndpointUseAffiliation
Other URL https://healthix.org/ Health Information Exchange (HIE)

National Provider Directory

National Provider Directory
Tax ID family
Brighton Medical Practice PC2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Practitioners & affiliated clinicians

Practitioners 1

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": "1571270400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1618358400000",
    "number": "1346883774",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "706 BANNER AVE",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112356957",
            "telephone_number": "718-368-3092",
            "fax_number": "718-368-2051"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "706 BANNER AVE",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112356957",
            "telephone_number": "718-368-3092",
            "fax_number": "718-368-2051"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BRIGHTON MEDICAL PRACTICE P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-10-17",
        "last_updated": "2021-04-14",
        "certification_date": "2021-04-14",
        "status": "A",
        "authorized_official_last_name": "MOMTAJ",
        "authorized_official_first_name": "SHILA",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "718-368-3092"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02743364",
            "state": "NY"
        }
    ],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "https://healthix.org/",
            "affiliation": "N",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "PDF",
            "address_1": "706 Banner Ave",
            "city": "Brooklyn",
            "state": "NY",
            "country_code": "US",
            "postal_code": "112356957",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "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 Apr 14, 2021; 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.