Organization Active NPI

Bay Ridge Gastroenterology, PLLC

  • Gastroenterology Physician
  • Brooklyn, NY
National Provider Identifier
1538816624
Registry record updated Mar 9, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gastroenterology PhysicianTaxonomy code 207RG0100X
Legal business name
BAY RIDGE GASTROENTEROLOGY, PLLC
Practice address
9920 4TH Ave Ste 205
Brooklyn, NY 11209-8328
Phone
(718) 745-0623
Fax
(718) 745-8091
NPI assigned
Mar 8, 2022
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 9, 2022

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

Authorized official

Name
Anila Hoxha
Title
Practice Manager
Phone
(718) 745-0623

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Gastroenterology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207RG0100X Primary

Addresses

Primary practice location

9920 4TH Ave Ste 205
Brooklyn, NY 11209-8328

Mailing address

9920 4TH Ave Ste 205
Brooklyn, NY 11209-8328
Phone (718) 745-0623

Other names 1

  • Bay Ridge Gastroenterology, PLLC Former legal business name

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20221216001014 NY Part B Supplier - Clinic/Group Practice 1658740469 Receives reassigned benefits from 4 practitioners
Practice locations: Brooklyn, 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
33D0145077Bay Ridge Gastroenterology PLLC9920 4TH Avenue, Suite 205, Brooklyn, NY 11209ComplianceMar 26, 2027

National Provider Directory

National Provider Directory

Locations

9920 4th Ave
Ste 205
Brooklyn, NY 11209
Phone (718) 238-4707

Practitioners & affiliated clinicians

Practitioners 4

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

NPI Registry JSON

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

{
    "created_epoch": "1646697600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1646784000000",
    "number": "1538816624",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9920 4TH AVE STE 205",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112098328",
            "telephone_number": "718-745-0623"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9920 4TH AVE STE 205",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112098328",
            "telephone_number": "718-745-0623",
            "fax_number": "718-745-8091"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BAY RIDGE GASTROENTEROLOGY, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-03-08",
        "last_updated": "2022-03-09",
        "certification_date": "2022-03-09",
        "status": "A",
        "authorized_official_last_name": "HOXHA",
        "authorized_official_first_name": "ANILA",
        "authorized_official_title_or_position": "PRACTICE MANAGER",
        "authorized_official_telephone_number": "718-745-0623"
    },
    "taxonomies": [
        {
            "code": "207RG0100X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine, Gastroenterology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Bay Ridge Gastroenterology, PLLC",
            "code": "4",
            "type": "Former Legal Business 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 Mar 9, 2022; 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.