Individual provider Active NPI

Jonathan Vaynberg, M.D.

  • Internal Medicine Physician
  • Brooklyn, NY
National Provider Identifier
1386007086
Registry record updated Sep 24, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
302636 Issued in NY
Practice address
450 Clarkson Ave # 1262
Brooklyn, NY 11203-2012
Phone
(718) 270-8867
NPI assigned
Mar 30, 2016
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 24, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 302636 NY Primary

Addresses

Primary practice location

450 Clarkson Ave # 1262
Brooklyn, NY 11203-2012

Mailing address

16 Braisted Ave
Staten Island, NY 10314-6123
Phone (917) 363-6881

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
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20241121004129 NY Practitioner - Internal MedicinePractitioner - General Practice 0840725255 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
State University of New York Downstate Medical Center, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Shore Medical PCGroup PAC ID 7810116761, 7 clinicians
Prominis Medical Services PCGroup PAC ID 9537124441, 43 clinicians

Practice addresses (Care Compare)

241 N Rd
Poughkeepsie, NY 12601-1154
Phone (845) 483-5000

2865 Brighton 3Rd St
Brooklyn, NY 11235-6762
Phone (718) 891-4400

288 Sand LN
Staten Island, NY 10305-4512
Phone (718) 556-3377

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Sun River Health Inc Current Accepting new patients
Sun River Health Inc CurrentSince Oct 28, 2024 Accepting new patients
Sun River Health Inc. CurrentSince Oct 28, 2024 Accepting new patients
New York Medical Physician Associates PC CurrentSince Sep 1, 2025 Accepting new patients
Prominis Medical Services PC Internal Medicine CurrentSince Feb 23, 2026 Accepting new patients
Shore Medical PC Internal Medicine CurrentSince Mar 1, 2025 Accepting new patients
New York Medical Physician Associates PC Internal Medicine CurrentSince Sep 1, 2025 Accepting new patients
Comprehensive Women's Health of N.Y. PLLC PastSince Jan 9, 2009 Accepting new patients

Locations

1601 Cummins Dr
Ste D
Modesto, CA 95358
Phone (510) 851-7423

3360 Route 343
Amenia, NY 12501
Phone (845) 373-9006

3035 W 24th St
Brooklyn, NY 11224
Phone (347) 348-1518

2865 Brighton 3rd St
Brooklyn, NY 11235
Phone (718) 645-1118

332 DeKalb Ave
Brooklyn, NY 11205
Phone 7185825252101

6451 Central Ave
Glendale, NY 11385
Phone (718) 669-7635

6829 Myrtle Ave
Glendale, NY 11385
Phone (718) 366-2242

1037 Main St
Peekskill, NY 10566
Phone (914) 734-8800

241 North Rd
Poughkeepsie, NY 12601
Phone (845) 431-8889

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 and National Provider Directory roles.

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1459296000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1727136000000",
    "number": "1386007086",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16 BRAISTED AVE",
            "city": "STATEN ISLAND",
            "state": "NY",
            "postal_code": "103146123",
            "telephone_number": "917-363-6881"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "450 CLARKSON AVE # 1262",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112032012",
            "telephone_number": "718-270-8867"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VAYNBERG",
        "first_name": "JONATHAN",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-03-30",
        "last_updated": "2024-09-24",
        "certification_date": "2024-09-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NY",
            "license": "302636",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brooklyn, NY

Sources for this page

Verify at the official NPI Registry.