NPIMap

Organization Active NPI

Ik Medical PC

  • Internal Medicine Physician
  • Brooklyn, NY
National Provider Identifier
1437813433
Registry record updated Jan 4, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
Legal business name
IK MEDICAL PC
Doing business as
IK Medical PC
Practice address
8401 Fort Hamilton Pkwy
Brooklyn, NY 11209-4805
Phone
(718) 759-0105
Fax
(718) 759-0800
NPI assigned
Oct 26, 2021
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 4, 2022

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

Authorized official

Name
Lorraine Carrara
Title
Biller
Phone
(631) 462-8783

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207R00000X Primary

Addresses

Primary practice location

8401 Fort Hamilton Pkwy
Brooklyn, NY 11209-4805

Mailing address

6500 Jericho Tpke Ste 206
Commack, NY 11725-2907
Phone (631) 462-8783

Other identifiers 1

IdentifierTypeStateIssuer
01849825MedicaidNY

Other names 1

  • IK Medical PC Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20220204000698 NY Part B Supplier - Clinic/Group Practice 2264825744 Receives reassigned benefits from 3 practitioners
Practice locations: Brooklyn, NY

National Provider Directory

National Provider Directory

Locations

6500 Jericho Tpke
Ste 206
Commack, NY 11725

Practitioners & affiliated clinicians

Practitioners 15

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

View all 15

NPI Registry JSON

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

{
    "created_epoch": "1635206400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1641254400000",
    "number": "1437813433",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6500 JERICHO TPKE STE 206",
            "city": "COMMACK",
            "state": "NY",
            "postal_code": "117252907",
            "telephone_number": "631-462-8783"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8401 FORT HAMILTON PKWY",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112094805",
            "telephone_number": "718-759-0105",
            "fax_number": "718-759-0800"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "IK MEDICAL PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-10-26",
        "last_updated": "2022-01-04",
        "certification_date": "2022-01-04",
        "status": "A",
        "authorized_official_last_name": "CARRARA",
        "authorized_official_first_name": "LORRAINE",
        "authorized_official_title_or_position": "BILLER",
        "authorized_official_telephone_number": "631-462-8783"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01849825",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "IK Medical PC",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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 Jan 4, 2022; 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.