Individual provider Active NPI

Jimmy Van, D.P.M.

  • Orthopaedic Surgery Physician
  • Brooklyn, NY
National Provider Identifier
1396032355
Registry record updated Mar 13, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthopaedic Surgery PhysicianTaxonomy code 207X00000X
License
N006604 Issued in NY
Practice address
443 Linden Blvd
Brooklyn, NY 11203-2821
Phone
(718) 282-6333
Fax
(718) 765-0545
NPI assigned
Jun 28, 2011
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 13, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Orthopaedic Surgery Physician 207X00000X N006604 NY Primary

Addresses

Primary practice location

443 Linden Blvd
Brooklyn, NY 11203-2821

Mailing address

443 Linden Blvd
Brooklyn, NY 11203-2821
Phone (718) 282-6333

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: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20150610000398 NY Practitioner - Podiatry 8921329335 Reassigns benefits to 1 organization
Practice locations: New York, NY; Brooklyn, NY

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
N006604NYMDOrthopaedic Surgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Interfaith Emergency Medicine, P.C. Current Accepting new patients
Interfaith Professional Physician Services, P.C. Orthopaedic Surgery CurrentSince Jul 1, 2020 Accepting new patients
Chinatown Cardiology, P.C. Past Accepting new patients
North Island Podiatry Associates P.C. PastSince Jul 1, 2022 Accepting new patients
Tribeca Internal Medicine & Acupuncture, P.C. Past Accepting new patients

Locations

1545 Atlantic Ave
Brooklyn, NY 11213
Phone (718) 613-4175

Networks

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

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/CFBDAA

Organizations & group practices 5

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": "1309219200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1426204800000",
    "number": "1396032355",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "443 LINDEN BLVD",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112032821",
            "telephone_number": "718-282-6333",
            "fax_number": "718-765-0545"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "443 LINDEN BLVD",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112032821",
            "telephone_number": "718-282-6333",
            "fax_number": "718-765-0545"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VAN",
        "first_name": "JIMMY",
        "credential": "D.P.M.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-06-28",
        "last_updated": "2015-03-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207X00000X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery",
            "state": "NY",
            "license": "N006604",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brooklyn, NY

Sources for this page

Verify at the official NPI Registry.