Individual provider Active NPI

Holson Serge Hector, MD

  • Pediatrics Physician
  • Brooklyn, NY
National Provider Identifier
1508081126
Registry record updated Feb 20, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
234127 Issued in NY
Practice address
562 E 93Rd St
Brooklyn, NY 11236-1102
Phone
(718) 345-1704
Fax
(718) 345-1376
NPI assigned
Apr 17, 2007
Last updated
Feb 20, 2024By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 20, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 234127 NY Primary

Addresses

Primary practice location

562 E 93Rd St
Brooklyn, NY 11236-1102

Mailing address

562 E 93Rd St
Brooklyn, NY 11236-1102
Phone (718) 345-1704

Other identifiers 1

IdentifierTypeStateIssuer
02728701MedicaidNY

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address hhector132623@nyumc.direct-ci.com NYU Langone Hospitals

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
I20141031000065 NY Practitioner - Family PracticePractitioner - Pediatric Medicine 3577582048 Reassigns benefits to 2 organizations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
NYU Langone Hospitals CurrentSince Jan 30, 2017 Accepting new patients
NYU Langone Hospitals Current Accepting new patients
NYU Langone Hospitals CurrentSince Jan 30, 2017 Accepting new patients
Millennium Medical Group PC Past Accepting new patients
Welllife Network Inc. Past Accepting new patients
Welllife Network Inc Past Accepting new patients
NYU Lutheran Medical Center Past Accepting new patients
NYU Langone Hospitals Past Accepting new patients

Locations

150 55th St
Brooklyn, NY 11220
Phone (718) 630-7123

150 55th St
Rm 3618
Brooklyn, NY 11220
Phone (718) 630-7477

3414 Church Ave
Brooklyn, NY 11203
Phone (718) 630-2197

301 E 17th St
New York, NY 10003
Phone (212) 598-2454

Networks

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

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/CFCABA/Endpoint/CFCABA

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1176768000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1708387200000",
    "number": "1508081126",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "562 E 93RD ST",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112361102",
            "telephone_number": "718-345-1704",
            "fax_number": "718-345-1376"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "562 E 93RD ST",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112361102",
            "telephone_number": "718-345-1704",
            "fax_number": "718-345-1376"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HECTOR",
        "first_name": "HOLSON",
        "middle_name": "SERGE",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-04-17",
        "last_updated": "2024-02-20",
        "certification_date": "2024-01-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "NY",
            "license": "234127",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02728701",
            "state": "NY"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "hhector132623@nyumc.direct-ci.com",
            "affiliation": "Y",
            "affiliationName": "NYU Langone Hospitals",
            "address_1": "150 55th St",
            "city": "Brooklyn",
            "state": "NY",
            "country_code": "US",
            "postal_code": "112202559",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Brooklyn, NY

Sources for this page

Verify at the official NPI Registry.