Organization Active NPI

Javier Zelaya, MD PC

  • Dermatology Physician
  • Brooklyn, NY
National Provider Identifier
1487786349
Registry record updated Jun 18, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dermatology PhysicianTaxonomy code 207N00000X
License
187832 Issued in NY
Legal business name
JAVIER ZELAYA, MD PC
Practice address
254 Prospect Park W
Brooklyn, NY 11215-5806
Phone
(718) 832-3313
NPI assigned
Mar 9, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 18, 2012

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

Authorized official

Name
Dr. Javier Arturo Zelaya, MDNPI 1760494355
Title
President
Phone
(718) 832-3313

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dermatology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207N00000X 187832 NY Primary

Addresses

Primary practice location

254 Prospect Park W
Brooklyn, NY 11215-5806

Mailing address

254 Prospect Park W
Brooklyn, NY 11215-5806
Phone (718) 832-3313

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20071001000805 NY Part B Supplier - Clinic/Group Practice 2961597224 Receives reassigned benefits from 3 practitioners
Practice locations: New York, NY; Maspeth, NY; Brooklyn, NY

National Provider Directory

National Provider Directory

Locations

254 Prospect Park W
Brooklyn, NY 11215
Phone (718) 208-4501

6077 Fresh Pond Rd
Maspeth, NY 11378
Phone (347) 808-6444

Practitioners & affiliated clinicians

Practitioners 5

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

NPI Registry JSON

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

{
    "created_epoch": "1173398400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1339977600000",
    "number": "1487786349",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "254 PROSPECT PARK W",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112155806",
            "telephone_number": "718-832-3313"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "254 PROSPECT PARK W",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112155806",
            "telephone_number": "718-832-3313"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JAVIER ZELAYA, MD PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-09",
        "last_updated": "2012-06-18",
        "status": "A",
        "authorized_official_last_name": "ZELAYA",
        "authorized_official_first_name": "JAVIER",
        "authorized_official_middle_name": "ARTURO",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "718-832-3313",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dermatology",
            "state": "NY",
            "license": "187832",
            "primary": true
        }
    ],
    "identifiers": [],
    "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 Jun 18, 2012; 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.