Active NPI
Enayatollah Hariri, M.D.
- Internal Medicine Physician
- Brooklyn, NY
National Provider Identifier
1376657247
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Internal Medicine Physician
- License
- 119476
- Practice address
- 2146 Beverley Rd
Brooklyn, NY 11226-5406 - Phone
- (718) 469-6600
- Fax
- (718) 856-0714
- NPI assigned
- Aug 18, 2006
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Internal Medicine Physician | 207R00000X | 119476 | NY | Primary |
Addresses
Primary practice location
2146 Beverley Rd
Brooklyn, NY 11226-5406
Mailing address
33 Aspen Dr
Livingston, NJ 07039-1430
Phone (718) 469-6600
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 00224117 | Medicaid | NY |
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
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20100922000927 | NY | Practitioner - Internal Medicine | 5193841575 | Practice locations: Brooklyn, NY |
Care Compare profile
Medicare Care Compare- Specialty
- Internal Medicine
- Education
- Other, 1966
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
Practice addresses (Care Compare)
2139 Beverley Rd
Brooklyn, NY 11226-5405
Phone (718) 469-6600
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 119476 | NY | MD | Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1155859200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1439769600000",
"number": "1376657247",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "33 ASPEN DR",
"city": "LIVINGSTON",
"state": "NJ",
"postal_code": "070391430",
"telephone_number": "718-469-6600",
"fax_number": "718-856-0714"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2146 BEVERLEY RD",
"city": "BROOKLYN",
"state": "NY",
"postal_code": "112265406",
"telephone_number": "718-469-6600",
"fax_number": "718-856-0714"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HARIRI",
"first_name": "ENAYATOLLAH",
"credential": "M.D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-08-18",
"last_updated": "2015-08-17",
"status": "A"
},
"taxonomies": [
{
"code": "207R00000X",
"taxonomy_group": "",
"desc": "Internal Medicine",
"state": "NY",
"license": "119476",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "00224117",
"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 Aug 17, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.