Statewide Medical Care LLC

Primary specialty

Emergency Medicine PhysicianTaxonomy code 207P00000X

Legal business name

STATEWIDE MEDICAL CARE LLC

Practice address

1675 59TH St
Brooklyn, NY 11204-2130

Phone

(917) 731-6672

NPI assigned

Apr 5, 2022

Organization subpart

No

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

Authorized official

Name

Blimy Jacobs

Title

Auth Official

Phone

(845) 662-2404

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1649116800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1649116800000",
    "number": "1467193201",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1675 59TH ST",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112042130",
            "telephone_number": "917-731-6672"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1675 59TH ST",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112042130",
            "telephone_number": "917-731-6672"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "STATEWIDE MEDICAL CARE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-04-05",
        "last_updated": "2022-04-05",
        "certification_date": "2022-04-05",
        "status": "A",
        "authorized_official_last_name": "JACOBS",
        "authorized_official_first_name": "BLIMY",
        "authorized_official_title_or_position": "AUTH OFFICIAL",
        "authorized_official_telephone_number": "845-662-2404"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Emergency Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Staten Island Eye Physicians PLLC
• Staten Island University Hospital
• Antonio Staten
• Skyler States
• Statewide Medical and Surgical Supplies Inc.
• Devorah Statfeld
• Itchie Statfeld, MD
• Maria Stathakos
• Henrietta Statham, LCSW
• Konstantinos Stathopoulos, D.D.S

• Emergency Medicine Physician in Brooklyn, NY
• Providers in Brooklyn, NY by specialty
• Emergency Medicine Physician in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 5, 2022; 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.