NPIMap

Organization Active NPI

Boro Park Operating Co LLC

  • Geriatric Medicine (Internal Medicine) Physician
  • Brooklyn, NY
National Provider Identifier
1427356930
Registry record updated Dec 31, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Geriatric Medicine (Internal Medicine) PhysicianTaxonomy code 207RG0300X
Legal business name
BORO PARK OPERATING CO LLC
Practice address
4915 10TH Ave
Brooklyn, NY 11219-3301
Phone
(718) 851-3700
NPI assigned
Mar 8, 2011
Last updated
Dec 31, 2019By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 31, 2019

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

Authorized official

Name
Kenneth Rozenberg
Title
Member
Phone
(718) 931-9700

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Geriatric Medicine (Internal Medicine) Physician 207RG0300X NU Primary

Addresses

Primary practice location

4915 10TH Ave
Brooklyn, NY 11219-3301

Mailing address

4770 White Plains Rd
Bronx, NY 10470-1104
Phone (718) 931-9700

Other names 1

  • Boro Park Physician Group Other name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20110912000152 NY Part B Supplier - Clinic/Group Practice 3577751320 Receives reassigned benefits from 32 practitioners
Practice locations: Brooklyn, NY

Other NPIs with the same Medicare PAC ID 1

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 32

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 32

NPI Registry JSON

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

{
    "created_epoch": "1299542400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1577750400000",
    "number": "1427356930",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4770 WHITE PLAINS RD",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "104701104",
            "telephone_number": "718-931-9700"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4915 10TH AVE",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112193301",
            "telephone_number": "718-851-3700"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BORO PARK OPERATING CO LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-03-08",
        "last_updated": "2019-12-31",
        "certification_date": "2019-12-31",
        "status": "A",
        "authorized_official_last_name": "ROZENBERG",
        "authorized_official_first_name": "KENNETH",
        "authorized_official_title_or_position": "MEMBER",
        "authorized_official_telephone_number": "718-931-9700"
    },
    "taxonomies": [
        {
            "code": "207RG0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Geriatric Medicine",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Boro Park Physician Group",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

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 31, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.