Individual provider Active NPI

Winston Kenneth Neckles, M.D.

  • Obstetrics & Gynecology Physician
  • Brooklyn, NY
National Provider Identifier
1386720720
Registry record updated Nov 14, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X
License
190536 Issued in NY
Practice address
1310 President St
Brooklyn, NY 11213-4238
Phone
(718) 363-1626
Fax
(718) 363-5462
NPI assigned
Oct 28, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 14, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics & Gynecology Physician 207V00000X 190536 NY Primary

Addresses

Primary practice location

1310 President St
Brooklyn, NY 11213-4238

Mailing address

1310 President St
Brooklyn, NY 11213-4238
Phone (718) 363-1626

Other identifiers 1

IdentifierTypeStateIssuer
01717564MedicaidNY

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
I20040508000240 NY Practitioner - Obstetrics/Gynecology 2860481504 Reassigns benefits to 2 organizations
Practice locations: Brooklyn, NY

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
190536NYMDObstetrics & Gynecology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
University Hospital of Brooklyn Suny Downstate Health Sciences Univers Obstetrics & Gynecology CurrentSince Jan 1, 2022 Accepting new patients
University Hospital of Brooklyn Suny Downstate Health Sciences Univers CurrentSince Jan 1, 2022 Accepting new patients
Be Well Primary Health Care Center, LLC CurrentSince Jul 19, 2024 Accepting new patients
University Hospital of Brooklyn Suny Downstate Health Sciences Univers Past Accepting new patients
Brooklyn Plaza Medical Center, Inc Past Accepting new patients
St. Barnabas OB GYN, PC Obstetrics & Gynecology Past Accepting new patients

Locations

445 Lenox Rd
#71
Brooklyn, NY 11203
Phone (718) 270-2030

3007 Farragut Rd
Brooklyn, NY 11210
Phone (347) 915-1177

470 Clarkson Ave
Brooklyn, NY 11203
Phone (718) 421-1003

Networks

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

Interoperability endpoints

  • Direct secure messaging: wnecklesuhb@wnm-ny.direct.office.nextgen.com
  • Direct secure messaging: winstonneckles@sunydmc.allscriptsdirect.net

Organizations & group practices 6

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.

NPI Registry JSON

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

{
    "created_epoch": "1161993600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1194998400000",
    "number": "1386720720",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1310 PRESIDENT ST",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112134238",
            "telephone_number": "718-363-1626"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1310 PRESIDENT ST",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112134238",
            "telephone_number": "718-363-1626",
            "fax_number": "718-363-5462"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NECKLES",
        "first_name": "WINSTON",
        "middle_name": "KENNETH",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-10-28",
        "last_updated": "2007-11-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "NY",
            "license": "190536",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01717564",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Brooklyn, NY

Sources for this page

Verify at the official NPI Registry.