NPIMap

Organization Active NPI

MMC Division of Neurology FPP

  • Neurology Physician
  • Brooklyn, NY
National Provider Identifier
1497838114
Registry record updated Aug 20, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neurology PhysicianTaxonomy code 2084N0400X
Legal business name
MMC DIVISION OF NEUROLOGY FPP
Practice address
883 65TH Street
Brooklyn, NY 11220
Phone
(718) 283-7470
Fax
(718) 635-6082
NPI assigned
Oct 24, 2006
Last updated
Aug 20, 2008By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 20, 2008

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

Authorized official

Name
Marshall Keilson, MDNPI 1528068954
Title
Director of Neurology
Phone
(718) 283-5858

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
Neurology Physician 2084N0400X Primary

Addresses

Primary practice location

883 65TH Street
Brooklyn, NY 11220

Mailing address

883 65TH Street
Brooklyn, NY 11220
Phone (718) 283-7470

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20041113000270 NY Part B Supplier - Clinic/Group Practice 6103880794 Receives reassigned benefits from 32 practitioners
Practice locations: Brooklyn, NY

National Provider Directory

National Provider Directory

Locations

883 65th St
Brooklyn, NY 11220
Phone (718) 283-6367

Practitioners & affiliated clinicians

Practitioners 35

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.

View all 35

NPI Registry JSON

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

{
    "created_epoch": "1161648000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1219190400000",
    "number": "1497838114",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "883 65TH STREET",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "11220",
            "telephone_number": "718-283-7470",
            "fax_number": "718-635-6082"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "883 65TH STREET",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "11220",
            "telephone_number": "718-283-7470",
            "fax_number": "718-635-6082"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MMC DIVISION OF NEUROLOGY FPP",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-24",
        "last_updated": "2008-08-20",
        "status": "A",
        "authorized_official_last_name": "KEILSON",
        "authorized_official_first_name": "MARSHALL",
        "authorized_official_title_or_position": "DIRECTOR OF NEUROLOGY",
        "authorized_official_telephone_number": "718-283-5858",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "2084N0400X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": null,
            "license": null,
            "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 Aug 20, 2008; 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.