NPIMap

Organization Active NPI

The Brookdale Hospital Medical Center

  • Mental Illness Community Based Residential Treatment Facility
  • Brooklyn, NY
National Provider Identifier
1538338702
Registry record updated Nov 15, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Illness Community Based Residential Treatment FacilityTaxonomy code 320800000X
Legal business name
THE BROOKDALE HOSPITAL MEDICAL CENTER
Practice address
1366 E New York Ave
Brooklyn, NY 11212-4535
Phone
(718) 613-6701
Fax
(718) 613-5725
NPI assigned
Feb 21, 2008
Last updated
Nov 15, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 15, 2024

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

Authorized official

Name
Charles Salvo
Title
Senior Vice President
Phone
(718) 240-6374

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Illness Community Based Residential Treatment Facility 320800000X Primary

Addresses

Primary practice location

1366 E New York Ave
Brooklyn, NY 11212-4535

Mailing address

10101 Avenue D
Imc Alternative Housing Program
Brooklyn, NY 11236-1902
Phone (718) 240-8534

Other identifiers 1

IdentifierTypeStateIssuer
02361526MedicaidNY

Other names 1

  • IMC Alternative Housing Program Other name

National Provider Directory

National Provider Directory
Tax ID family
Imc Associates Surgery10 organizations share this tax ID, including this one

Other organizations with this tax ID 9

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

Locations

1366 E New York Ave
Brooklyn, NY 11212
Phone (718) 613-6701

Practitioners & affiliated clinicians

Practitioners 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1203552000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1731628800000",
    "number": "1538338702",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10101 AVENUE D",
            "address_2": "IMC ALTERNATIVE HOUSING PROGRAM",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112361902",
            "telephone_number": "718-240-8534",
            "fax_number": "718-240-6492"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1366 E NEW YORK AVE",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112124535",
            "telephone_number": "718-613-6701",
            "fax_number": "718-613-5725"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "THE BROOKDALE HOSPITAL MEDICAL CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-02-21",
        "last_updated": "2024-11-15",
        "certification_date": "2024-11-13",
        "status": "A",
        "authorized_official_last_name": "SALVO",
        "authorized_official_first_name": "CHARLES",
        "authorized_official_title_or_position": "SENIOR VICE PRESIDENT",
        "authorized_official_telephone_number": "718-240-6374"
    },
    "taxonomies": [
        {
            "code": "320800000X",
            "taxonomy_group": "",
            "desc": "Community Based Residential Treatment Facility, Mental Illness",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02361526",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "IMC Alternative Housing Program",
            "code": "5",
            "type": "Other Name"
        },
        {
            "organization_name": "IMC Alternative Housing Program",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

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 Nov 15, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.