NPIMap

Organization Active NPI

Medcare, LLC

  • Family Medicine Physician
  • Brooklyn, NY
National Provider Identifier
1508993650
Registry record updated Apr 7, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
219313 Issued in NY
Legal business name
MEDCARE, LLC
Practice address
468 Lafayette Ave
Brooklyn, NY 11205-4809
Phone
(718) 399-6234
Fax
(718) 399-3516
NPI assigned
Feb 27, 2007
Last updated
Apr 7, 2015By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 7, 2015

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

Authorized official

Name
Sofiya Keisserman
Title
Owner/Administrator
Phone
(718) 399-6234

Specialties & licenses 8

Specialty (taxonomy)CodeLicenseStatePrimary
OptometristGroup: 193200000X MULTI-SPECIALTY GROUP 152W00000X TUV006926 NY
Family Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207Q00000X 219313 NY Primary
Internal Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207R00000X 218384 NY
Cardiovascular Disease PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207RC0000X 127692 NY
Endocrinology, Diabetes & Metabolism PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207RE0101X 174588 NY
Obstetrics & Gynecology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207V00000X 233517 NY
PodiatristGroup: 193200000X MULTI-SPECIALTY GROUP 213E00000X N006039 NY
Physical TherapistGroup: 193200000X MULTI-SPECIALTY GROUP 225100000X 026957 NY

Addresses

Primary practice location

468 Lafayette Ave
Brooklyn, NY 11205-4809

Mailing address

468 Lafayette Ave
Brooklyn, NY 11205-4809
Phone (718) 399-6234

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20070511000578 NY Part B Supplier - Clinic/Group Practice 9537265541 Receives reassigned benefits from 31 practitioners
Practice locations: Brooklyn, NY; Monsey, NY; Pomona, NY

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
33D1069834Medcare LLC468 Lafayette Avenue, Brooklyn, NY 11205Certificate of waiverMar 26, 2027

National Provider Directory

National Provider Directory

Locations

75 Route 59
Monsey, NY 10952
Phone (845) 356-2273

Practitioners & affiliated clinicians

Practitioners 54

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 54

NPI Registry JSON

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

{
    "created_epoch": "1172534400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1428364800000",
    "number": "1508993650",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "468 LAFAYETTE AVE",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112054809",
            "telephone_number": "718-399-6234",
            "fax_number": "718-399-3516"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "468 LAFAYETTE AVE",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112054809",
            "telephone_number": "718-399-6234",
            "fax_number": "718-399-3516"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MEDCARE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-27",
        "last_updated": "2015-04-07",
        "status": "A",
        "authorized_official_last_name": "KEISSERMAN",
        "authorized_official_first_name": "SOFIYA",
        "authorized_official_title_or_position": "OWNER/ADMINISTRATOR",
        "authorized_official_telephone_number": "718-399-6234"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Optometrist",
            "state": "NY",
            "license": "TUV006926",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": "NY",
            "license": "219313",
            "primary": true
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine",
            "state": "NY",
            "license": "218384",
            "primary": false
        },
        {
            "code": "207RC0000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "NY",
            "license": "127692",
            "primary": false
        },
        {
            "code": "207RE0101X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine, Endocrinology, Diabetes & Metabolism",
            "state": "NY",
            "license": "174588",
            "primary": false
        },
        {
            "code": "207V00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Obstetrics & Gynecology",
            "state": "NY",
            "license": "233517",
            "primary": false
        },
        {
            "code": "213E00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Podiatrist",
            "state": "NY",
            "license": "N006039",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physical Therapist",
            "state": "NY",
            "license": "026957",
            "primary": false
        }
    ],
    "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 Apr 7, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.