Individual provider Active NPI

Nathan Dudley Molina, M.D.

  • Plastic and Reconstructive Surgery Physician
  • Brooklyn, NY
National Provider Identifier
1477084697
Registry record updated Apr 25, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Plastic and Reconstructive Surgery PhysicianTaxonomy code 2086S0122X
License
316849 Issued in NY
Practice address
300 Kent Ave Ste 605
Brooklyn, NY 11249-4357
Phone
(718) 208-4577
NPI assigned
Mar 21, 2017
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 25, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Plastic and Reconstructive Surgery Physician 2086S0122X 316849 NY Primary

Addresses

Primary practice location

300 Kent Ave Ste 605
Brooklyn, NY 11249-4357

Mailing address

300 Kent Ave Ste 605
Brooklyn, NY 11249-4357
Phone (718) 208-4577

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
I20230912000668 NY Practitioner - Plastic and Reconstructive Surgery 4688910680 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Plastic and Reconstructive Surgery
Education
University of California, Irvine, California College of Medicine, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Interfaith Professional Physician Services PCGroup PAC ID 9931378171, 383 clinicians

Practice addresses (Care Compare)

1545 Atlantic Ave
Brooklyn, NY 11213-1122
Phone (718) 613-4000

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of tissue1-10

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Brookdale Hospital Medical Center CurrentSince Dec 1, 2023 Accepting new patients
The Brookdale Hospital Medical Center CurrentSince Dec 1, 2023 Accepting new patients
Interfaith Professional Physician Services, P.C. CurrentSince Feb 14, 2024 Accepting new patients

Locations

9413 Flatlands Ave
Ste 201W
Brooklyn, NY 11236
Phone (310) 867-3504

1545 Atlantic Ave
Brooklyn, NY 11213
Phone (718) 613-4175

1235 Linden Blvd
Fl 2
Brooklyn, NY 11212
Phone (718) 240-7143

Networks

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

Interoperability endpoints

  • Direct secure messaging: nmolina@drmolina.emadirect.md

Organizations & group practices 3

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

NPI Registry JSON

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

{
    "created_epoch": "1490054400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1745539200000",
    "number": "1477084697",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "300 KENT AVE STE 605",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112494357",
            "telephone_number": "718-208-4577"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "300 KENT AVE STE 605",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112494357",
            "telephone_number": "718-208-4577"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOLINA",
        "first_name": "NATHAN",
        "middle_name": "DUDLEY",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2017-03-21",
        "last_updated": "2025-04-25",
        "certification_date": "2025-04-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2086S0122X",
            "taxonomy_group": "",
            "desc": "Surgery, Plastic and Reconstructive Surgery",
            "state": "NY",
            "license": "316849",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brooklyn, NY

Sources for this page

Verify at the official NPI Registry.