Individual provider Active NPI

Martin H Broker, MD

  • Diagnostic Radiology Physician
  • Brooklyn, NY
National Provider Identifier
1376590513
Registry record updated Oct 26, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
License
152514 Issued in NY
Practice address
3131 Kings Hwy
Suite a-4
Brooklyn, NY 11234-2644
Phone
(718) 758-1500
Fax
(718) 758-2400
NPI assigned
May 30, 2006
Last updated
Oct 26, 2007By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 26, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Radiology Physician 2085R0202X 152514 NY Primary

Addresses

Primary practice location

3131 Kings Hwy
Suite a-4
Brooklyn, NY 11234-2644

Mailing address

10 Exchange PL
14TH Floor WSBS
Jersey City, NJ 07302-3918
Phone (201) 830-3122

Other identifiers 1

IdentifierTypeStateIssuer
01049793MedicaidNY

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Eligible to order & refer
  • Part B services: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Fpa Hospital Based Current Accepting new patients
Fpa Hospital Based Diagnostic Radiology CurrentSince Aug 16, 2023 Accepting new patients
Bimc Faculty Practice Past Accepting new patients
Bimc Radiology Diagnostic Radiology Past Accepting new patients
SLR Diagnostic Radiology, P.C. Diagnostic Radiology Past Accepting new patients
East Manhattan Diagnostic Imaging, P.C. Diagnostic Radiology Past Accepting new patients
Bimc Faculty Practice Past Accepting new patients
Beth Israel Medical Center Diagnostic Radiology Past Accepting new patients

Locations

3712 82nd St
Jackson Hts, NY 11372
Phone (718) 879-1600

1176 5th Ave
New York, NY 10029
Phone (212) 241-6237

Networks

  • Healthfirst Medicare Network H5989
  • Healthfirst Medicare Network H1722
  • Healthfirst Medicare Network H9678
  • Healthfirst Medicare Network H3359

Organizations & group practices 8

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1148947200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1193356800000",
    "number": "1376590513",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10 EXCHANGE PL",
            "address_2": "14TH FLOOR WSBS",
            "city": "JERSEY CITY",
            "state": "NJ",
            "postal_code": "073023918",
            "telephone_number": "201-830-3122",
            "fax_number": "201-200-0838"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3131 KINGS HWY",
            "address_2": "SUITE A-4",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112342644",
            "telephone_number": "718-758-1500",
            "fax_number": "718-758-2400"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BROKER",
        "first_name": "MARTIN",
        "middle_name": "H",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-30",
        "last_updated": "2007-10-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "NY",
            "license": "152514",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01049793",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Brooklyn, NY

Sources for this page

Verify at the official NPI Registry.