Individual provider Active NPI

Yechiel Zagelbaum, DO

  • Pediatrics Physician
  • Brooklyn, NY
National Provider Identifier
1558452730
Registry record updated Sep 20, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
215102 Issued in NY
Practice address
200 Wallabout St Apt 3C
Brooklyn, NY 11206-5541
Phone
(718) 486-9800
Fax
(718) 486-5553
NPI assigned
Sep 27, 2006
Last updated
Sep 20, 2018By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 20, 2018

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 215102 NY Primary

Addresses

Primary practice location

200 Wallabout St Apt 3C
Brooklyn, NY 11206-5541

Mailing address

1453 East 26TH St.
Brooklyn, NY 11210
Phone (718) 486-9800

Other identifiers 1

IdentifierTypeStateIssuer
02225309MedicaidNY

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
I20230130000288 NY Practitioner - Pediatric Medicine 3870671738 Reassigns benefits to 1 organization

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Maimonides Medical Center Current Accepting new patients
Urgi-Med Family Medical Center Current Accepting new patients
Finif Medical, PC CurrentSince Dec 1, 2022 Accepting new patients
Ernc Operating, LLC PastSince Jan 1, 2013 Accepting new patients
Womens League Community Residence Past Accepting new patients
University Group Medical Associates, P.C Pediatrics Past Accepting new patients
Kayla Pediatrics, PC Pediatrics Past Accepting new patients
Maimonides Medical Center - MMC Emergency Physicians FPP Past Accepting new patients

Locations

200 Wallabout St
Ste 1C
Brooklyn, NY 11206
Phone (718) 301-8825

4802 10th Ave
Brooklyn, NY 11219
Phone (718) 283-8724

Networks

  • Healthfirst Medicare Network H5989
  • Healthfirst Medicare Network H1722
  • Healthfirst Medicare Network H9678
  • Healthfirst Medicare Network H3359

Interoperability endpoints

  • Direct secure messaging: yechielzagelbaum@mai.allscriptsdirect.net
  • Direct secure messaging: yez4001@direct.nyp.org

Ownership & related parties

All facility ownership & control disclosures 6

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Pharney Group LLC.Tarrytown, NY, CCN 335421 Skilled nursing facility 5% Or Greater Direct Ownership Interest (13.5%) Apr 1, 2008
Alpine Rehabilitation and Nursing CenterLittle Falls, NY, CCN 335586 Skilled nursing facility 5% Or Greater Direct Ownership Interest (21%) Mar 11, 2008
Norwich Rehabilitation and Nursing CenterNorwich, NY, CCN 335759 Skilled nursing facility 5% Or Greater Direct Ownership Interest (21%) Jun 24, 2009
Yorktown Rehabilitation & Nursing CenterCortlandt Manor, NY, CCN 335078 Skilled nursing facility 5% Or Greater Direct Ownership Interest (21%) Oct 9, 2015
Orchard Rehabilitation & Nursing CenterMedina, NY, CCN 335397 Skilled nursing facility Corporate Officer Sep 6, 2016
Massena Rehab and Nursing CenterMassena, NY, CCN 335592 Skilled nursing facility 5% Or Greater Direct Ownership Interest (21%) Dec 31, 2020

Owned or controlled facilities with NPI records 6

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

Organizations & group practices 10

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1159315200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1537401600000",
    "number": "1558452730",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1453 EAST 26TH ST.",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "11210",
            "telephone_number": "718-486-9800",
            "fax_number": "718-486-5553"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 WALLABOUT ST APT 3C",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112065541",
            "telephone_number": "718-486-9800",
            "fax_number": "718-486-5553"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ZAGELBAUM",
        "first_name": "YECHIEL",
        "name_prefix": "Dr.",
        "credential": "DO",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-09-27",
        "last_updated": "2018-09-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "NY",
            "license": "215102",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02225309",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Brooklyn, NY

Sources for this page

Verify at the official NPI Registry.