Individual provider Active NPI

Elsayed Hammad Eldeeb, MD

  • Family Medicine Physician
  • Brooklyn, NY
National Provider Identifier
1417287400
Registry record updated Apr 18, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
262324 Issued in NY
Practice address
1946 Bath Ave
# 1
Brooklyn, NY 11214-4704
Phone
(347) 866-8103
Fax
(718) 871-8950
NPI assigned
Jan 13, 2010
Last updated
Apr 18, 2017By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 18, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 262324 NY Primary

Addresses

Primary practice location

1946 Bath Ave
# 1
Brooklyn, NY 11214-4704

Mailing address

1946 Bath Ave
Brooklyn, NY 11214-4704
Phone (718) 996-7460

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
I20120202000564 NY Practitioner - Family PracticePractitioner - Internal Medicine 2769649771 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family PracticeAlso: Internal Medicine
Education
Other, 2002
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

1946 Bath Ave
Brooklyn, NY 11214-4704
Phone (718) 996-7460

National Provider Directory

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

Networks

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

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1263340800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1492473600000",
    "number": "1417287400",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1946 BATH AVE",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112144704",
            "telephone_number": "718-996-7460",
            "fax_number": "718-996-7461"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1946 BATH AVE",
            "address_2": "# 1",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112144704",
            "telephone_number": "347-866-8103",
            "fax_number": "718-871-8950"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ELDEEB",
        "first_name": "ELSAYED",
        "middle_name": "HAMMAD",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2010-01-13",
        "last_updated": "2017-04-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NY",
            "license": "262324",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brooklyn, NY

Sources for this page

Verify at the official NPI Registry.