Active NPI
Elaine Elyshia Pass, M.D.
- Family Medicine Physician
- Brooklyn, NY
National Provider Identifier
1487637278
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- License
- 097408
- Practice address
- 820 Broadway
Floor 1
Brooklyn, NY 11206-7305 - Phone
- (718) 599-0477
- Fax
- (718) 599-8677
- NPI assigned
- Nov 25, 2005
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | 097408 | NY | Primary |
Addresses
Primary practice location
820 Broadway
Floor 1
Brooklyn, NY 11206-7305
Mailing address
101 W 12TH St
12W
New York, NY 10011-8142
Phone (718) 599-0477
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 00164049 | Medicaid | NY |
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
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20070321000502 | NY | Practitioner - Family Practice | 1658474119 | Practice locations: Brooklyn, NY |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Lawrence Nalitt | Past | Accepting new patients |
Organizations & group practices 1
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.
-
- General Practice Dentistry
- Brooklyn, NY
- NPI 1639315658
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1132876800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1783900800000",
"number": "1487637278",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "101 W 12TH ST",
"address_2": "12W",
"city": "NEW YORK",
"state": "NY",
"postal_code": "100118142",
"telephone_number": "718-599-0477",
"fax_number": "718-599-8677"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "820 BROADWAY",
"address_2": "FLOOR 1",
"city": "BROOKLYN",
"state": "NY",
"postal_code": "112067305",
"telephone_number": "718-599-0477",
"fax_number": "718-599-8677"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PASS",
"first_name": "ELAINE",
"middle_name": "ELYSHIA",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2005-11-25",
"last_updated": "2026-07-13",
"status": "A"
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "NY",
"license": "097408",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "00164049",
"state": "NY"
}
],
"endpoints": [],
"other_names": []
}
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 Jul 13, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.