Individual provider Active NPI

Everton A. Prospere, M.D.

  • Internal Medicine Physician
  • Brooklyn, NY
National Provider Identifier
1497740807
Registry record updated Apr 17, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
226783-1 Issued in NY
Practice address
450 Clarkson Ave
Suite a
Brooklyn, NY 11203-2056
Phone
(718) 270-1531
Fax
(718) 270-1561
NPI assigned
Sep 13, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 17, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 226783-1 NY Primary

Addresses

Primary practice location

450 Clarkson Ave
Suite a
Brooklyn, NY 11203-2056

Mailing address

450 Clarkson Ave
Box 59
Brooklyn, NY 11203-2056
Phone (718) 270-8867

Other identifiers 1

IdentifierTypeStateIssuer
02367173MedicaidNY

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
I20040329001805 NY Practitioner - Internal MedicinePractitioner - Geriatric Medicine 3779475090 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal MedicineAlso: Geriatric Medicine
Education
New York University School of Medicine, 1999
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
University Physicians of Brooklyn, Inc.Group PAC ID 0749192284, 174 clinicians

Practice addresses (Care Compare)

450 Clarkson Ave
Brooklyn, NY 11203-2098

470 Clarkson Ave
Brooklyn, NY 11203-2012
Phone (718) 270-1000

612 Schenectady Ave
Brooklyn, NY 11203-1821
Phone (347) 365-6142

Hospital & facility affiliations

  • Suny/Downstate University Hospital of Brooklyn Hospital, Brooklyn, NY, CCN 330350

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
226783-1NYMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
University Physicians of Brooklyn, Inc. Internal Medicine CurrentSince Jul 1, 2003 Accepting new patients
University Hospital of Brooklyn Suny Downstate Health Sciences Univers CurrentSince Jan 1, 2022 Accepting new patients
University Physicians of Brooklyn, Inc. Current Accepting new patients
University Hospital of Brooklyn Suny Downstate Health Sciences Univers Internal Medicine CurrentSince Jan 1, 2022 Accepting new patients
University Physicians of Brooklyn, Inc. CurrentSince Jul 1, 2003 Accepting new patients
Eaw Medical Care PLLC CurrentSince Jul 15, 2008 Accepting new patients
RB Medical Practice, PC Internal Medicine CurrentSince Feb 27, 2022 Accepting new patients
University Physicians of Brooklyn, Inc Past Accepting new patients
University Physicians of Brooklyn, Inc. Past Accepting new patients

Locations

450 Clarkson Ave
Ste A
Brooklyn, NY 11203
Phone (718) 270-1432

450 Clarkson Ave
#80
Brooklyn, NY 11203
Phone (718) 613-8481

450 Clarkson Ave
Brooklyn, NY 11203
Phone (718) 270-1603

612 Schenectady Ave
Brooklyn, NY 11203
Phone (347) 365-6142

450 Clarkson Ave
#59
Brooklyn, NY 11203
Phone (718) 270-2078

470 Clarkson Ave
Brooklyn, NY 11203
Phone (718) 421-1003

840 Lefferts Ave
Brooklyn, NY 11203
Phone (718) 493-0300

Networks

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

Organizations & group practices 9

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.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1126569600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1239926400000",
    "number": "1497740807",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "450 CLARKSON AVE",
            "address_2": "BOX 59",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112032056",
            "telephone_number": "718-270-8867",
            "fax_number": "718-270-1794"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "450 CLARKSON AVE",
            "address_2": "SUITE A",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112032056",
            "telephone_number": "718-270-1531",
            "fax_number": "718-270-1561"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PROSPERE",
        "first_name": "EVERTON",
        "middle_name": "A.",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-09-13",
        "last_updated": "2009-04-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NY",
            "license": "226783-1",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02367173",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Brooklyn, NY

Sources for this page

Verify at the official NPI Registry.