Organization Active NPI

Hillside Advanced Medical P.C.

  • Family Medicine Physician
  • Brooklyn, NY
National Provider Identifier
1407877574
Registry record updated Dec 12, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
203451 Issued in NY
Legal business name
HILLSIDE ADVANCED MEDICAL P.C.
Practice address
401 Ocean View Ave
Brooklyn, NY 11235-6828
Phone
(718) 332-7551
Fax
(718) 332-6385
NPI assigned
Jul 22, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 12, 2012

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

Authorized official

Name
Dr. Marat Tsirlin, M.D.
Title
President
Phone
(718) 332-7551

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207Q00000X 203451 NY Primary

Addresses

Primary practice location

401 Ocean View Ave
Brooklyn, NY 11235-6828

Mailing address

401 Ocean View Ave
Level C
Brooklyn, NY 11235-6828
Phone (718) 332-7551

Other identifiers 1

IdentifierTypeStateIssuer
02167628MedicaidNY

National Provider Directory

National Provider Directory

Locations

401 Ocean View Ave
#C
Brooklyn, NY 11235
Phone (718) 332-7551

401 Ocean View Ave
Brooklyn, NY 11235
Phone (718) 332-7551

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1153526400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1355270400000",
    "number": "1407877574",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "401 OCEAN VIEW AVE",
            "address_2": "LEVEL C",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112356828",
            "telephone_number": "718-332-7551",
            "fax_number": "718-332-6385"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "401 OCEAN VIEW AVE",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112356828",
            "telephone_number": "718-332-7551",
            "fax_number": "718-332-6385"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HILLSIDE ADVANCED MEDICAL P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-22",
        "last_updated": "2012-12-12",
        "status": "A",
        "authorized_official_last_name": "TSIRLIN",
        "authorized_official_first_name": "MARAT",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "718-332-7551",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": "NY",
            "license": "203451",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02167628",
            "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 Dec 12, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.