NPIMap

Organization Active NPI

State of New York

  • Intellectual Disabilities Intermediate Care Facility
  • Brooklyn, NY
National Provider Identifier
1467592915
Registry record updated Jun 26, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Intellectual Disabilities Intermediate Care FacilityTaxonomy code 315P00000X
License
00235629 Issued in NY
Legal business name
STATE OF NEW YORK
Practice address
960 Elton St
Brooklyn, NY 11208-5418
Phone
(518) 402-4333
NPI assigned
Feb 7, 2007
Last updated
Jun 26, 2008By the provider in NPPES
Organization subpart
Yes
Parent organization
STATE OF NEW YORKAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Jun 26, 2008

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

Authorized official

Name
Karla Smith
Title
Principal Account Clerk
Phone
(518) 402-4333

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Intellectual Disabilities Intermediate Care Facility 315P00000X 00235629 NY Primary

Addresses

Primary practice location

960 Elton St
Brooklyn, NY 11208-5418

Mailing address

44 Holland Ave
Albany, NY 12229-0001
Phone (518) 402-4333

Other identifiers 1

IdentifierTypeStateIssuer
00945446MedicaidNY

Other names 1

  • Brooklyn DC T shirtz #1 ICF Other name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1467592915. Details of each certification follow.

  • CCN 33G717 Intermediate care facility for individuals with intellectual disabilities · Active · Name & address match · Details

Intermediate care facility for individuals with intellectual disabilities certification: CCN 33G717

Name & address match This certification has no NPI in the Medicare enrollment files. CMS publishes enrollment files for six facility types only, so it was connected to this NPI by matching the name and address CMS publishes for it.

Legal name
BROOKLYN DDSO - THOMAS SHIRTZ I I C F
Certification status
Active
Provider type (POS)
Intermediate care facility for individuals with intellectual disabilities
Participating since
Mar 31, 1986
Last certification
Nov 14, 2025
Beds
22
Ownership / control type
State
Facility address
960 Elton St
Brooklyn, NY 11208

National Provider Directory

National Provider Directory
Tax ID family
RPC-Middletown Mental Health Clinic269 organizations share this tax ID, including this one
Part of
RPC-Middletown Mental Health Clinic

Organizations with this tax ID in the same state 24

This tax ID family is large, so up to 24 of its organizations in the same state are linked here.

View all 24

Locations

960 Elton St
Brooklyn, NY 11208
Phone (347) 267-2215

Practitioners & affiliated clinicians

Practitioners 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1170806400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1214438400000",
    "number": "1467592915",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "44 HOLLAND AVE",
            "city": "ALBANY",
            "state": "NY",
            "postal_code": "122290001",
            "telephone_number": "518-402-4333"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "960 ELTON ST",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112085418",
            "telephone_number": "518-402-4333"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "STATE OF NEW YORK",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "STATE OF NEW YORK",
        "enumeration_date": "2007-02-07",
        "last_updated": "2008-06-26",
        "status": "A",
        "authorized_official_last_name": "SMITH",
        "authorized_official_first_name": "KARLA",
        "authorized_official_title_or_position": "PRINCIPAL ACCOUNT CLERK",
        "authorized_official_telephone_number": "518-402-4333"
    },
    "taxonomies": [
        {
            "code": "315P00000X",
            "taxonomy_group": "",
            "desc": "Intermediate Care Facility, Intellectual Disabilities",
            "state": "NY",
            "license": "00235629",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00945446",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Brooklyn DC T shirtz #1 ICF",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Brooklyn, NY

Sources for this page

Verify at the official NPI Registry.