Individual provider Active NPI

Samia Rafik Makaryus, M.D.

  • Pediatrics Physician
  • Brooklyn, NY
National Provider Identifier
1548561004
Registry record updated Nov 15, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
175532 Issued in NY
Practice address
760 Broadway
Pediatric Department
Brooklyn, NY 11206
Phone
(718) 963-8040
Fax
(718) 630-3461
NPI assigned
Nov 15, 2010
Last updated
Nov 15, 2010By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 15, 2010

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 175532 NY Primary

Addresses

Primary practice location

760 Broadway
Pediatric Department
Brooklyn, NY 11206

Mailing address

760 Broadway
Pediatric Department
Brooklyn, NY 11206
Phone (718) 963-8040

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
I20161216000275 NY Order and Referring Only - Pediatric MedicinePractitioner - Pediatric Medicine 0648269217

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
175532NYMDPediatrics Physician

Interoperability endpoints

  • Direct secure messaging: smakaryus563022@nychhc.direct-ci.com

NPI Registry JSON

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

{
    "created_epoch": "1289779200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1289779200000",
    "number": "1548561004",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "760 BROADWAY",
            "address_2": "PEDIATRIC DEPARTMENT",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "11206",
            "telephone_number": "718-963-8040",
            "fax_number": "718-630-3461"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "760 BROADWAY",
            "address_2": "PEDIATRIC DEPARTMENT",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "11206",
            "telephone_number": "718-963-8040",
            "fax_number": "718-630-3461"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MAKARYUS",
        "first_name": "SAMIA",
        "middle_name": "RAFIK",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-11-15",
        "last_updated": "2010-11-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "NY",
            "license": "175532",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brooklyn, NY

Sources for this page

Verify at the official NPI Registry.