NPIMap

Organization Active NPI

MMC Division of General Thoracic Surgery F P P

  • Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
  • Brooklyn, NY
National Provider Identifier
1508969494
Registry record updated Feb 13, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Thoracic Surgery (Cardiothoracic Vascular Surgery) PhysicianTaxonomy code 208G00000X
Legal business name
MMC DIVISION OF GENERAL THORACIC SURGERY F P P
Practice address
4802 10TH Ave
Brooklyn, NY 11219-2916
Phone
(718) 283-8773
NPI assigned
Sep 6, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 13, 2013

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

Authorized official

Name
Joseph Lo Cicero, MDNPI 1629082383
Title
Authorized Official
Phone
(718) 283-8773

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
Thoracic Surgery (Cardiothoracic Vascular Surgery) PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 208G00000X Primary

Addresses

Primary practice location

4802 10TH Ave
Brooklyn, NY 11219-2916

Mailing address

Gpo 30060
New York, NY 10087-0060

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20070625000084 NY Part B Supplier - Clinic/Group Practice 1153420617 Receives reassigned benefits from 8 practitioners
Practice locations: Brooklyn, NY

National Provider Directory

National Provider Directory
Tax ID family
Maimonides Medical Center2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Locations

3619 Bedford Ave
Ste 1M
Brooklyn, NY 11210
Phone (718) 283-7045

Gpo 30060
New York, NY 10087

Practitioners & affiliated clinicians

Practitioners 27

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

View all 27

NPI Registry JSON

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

{
    "created_epoch": "1157500800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1360713600000",
    "number": "1508969494",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "GPO 30060",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100870060"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4802 10TH AVE",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112192916",
            "telephone_number": "718-283-8773"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MMC DIVISION OF GENERAL THORACIC SURGERY F P P",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-06",
        "last_updated": "2013-02-13",
        "status": "A",
        "authorized_official_last_name": "LO CICERO",
        "authorized_official_first_name": "JOSEPH",
        "authorized_official_title_or_position": "AUTHORIZED OFFICIAL",
        "authorized_official_telephone_number": "718-283-8773",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "208G00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Thoracic Surgery (Cardiothoracic Vascular Surgery)",
            "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 Feb 13, 2013; 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.