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Organization Active NPI

Suny Health Science Center at Bklyn

  • Emergency Medicine Physician
  • Brooklyn, NY
National Provider Identifier
1588077994
Registry record updated Sep 24, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
Legal business name
SUNY HEALTH SCIENCE CENTER AT BKLYN
Practice address
470 Clarkson Ave
Brooklyn, NY 11203-2012
Phone
(718) 270-1000
NPI assigned
Jun 4, 2014
Last updated
Sep 24, 2014By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 24, 2014

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

Authorized official

Name
Richard Miller
Title
Ceo
Phone
(718) 826-4901

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X NU Primary
Urgent Care Clinic/Center 261QU0200X NU

Addresses

Primary practice location

470 Clarkson Ave
Brooklyn, NY 11203-2012

Mailing address

450 Clarkson Ave
Brooklyn, NY 11203-2012
Phone (718) 270-1000

Other names 1

  • University Hospital of Brooklyn Other name

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20150129000656 NY Part B Supplier - Clinic/Group Practice 0840101770 Receives reassigned benefits from 67 practitioners
Practice locations: Brooklyn, NY

Other NPIs with the same Medicare PAC ID 15

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

View all 15

National Provider Directory

National Provider Directory
Tax ID family
Wilton Devel Ctr Rev M269 organizations share this tax ID, including this one

Organizations with this tax ID in the same state 24

This tax ID family is large, so up to 24 of its organizations in the same state are linked here.

View all 24

Ownership & related parties

All facility ownership & control disclosures 13

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

FacilityTypeRoleSince
Helen Hayes HospitalWest Haverstraw, NY, CCN 330405 Hospital 5% Or Greater Direct Ownership Interest (100%) Jan 1, 1966
Suny Health Science Center at SyracuseSyracuse, NY, CCN 33S241 Hospital 5% Or Greater Direct Ownership Interest (100%) Jul 1, 1966
Suny Health Science Center at SyracuseSyracuse, NY, CCN 33T241 Hospital 5% Or Greater Direct Ownership Interest (100%) Jul 1, 1966
Helen Hayes HospitalWest Haverstraw, NY, CCN 33T405 Hospital 5% Or Greater Direct Ownership Interest (100%) Jan 1, 1966
University Hospital of Brooklyn Suny Downstate Health Sciences UniversBrooklyn, NY, CCN 330350 Hospital 5% Or Greater Indirect Ownership Interest Dec 22, 1966
University Hospital of Brooklyn Suny Downstate Health Sciences UniversBrooklyn, NY, CCN 33T350 Hospital 5% Or Greater Indirect Ownership Interest Dec 22, 1966
Nys Veterans Home at MontroseMontrose, NY, CCN 335832 Skilled nursing facility 5% Or Greater Direct Ownership Interest (100%) Sep 11, 2001
Long Island State Veterans HomeStony Brook, NY, CCN 335758 Skilled nursing facility 5% Or Greater Direct Ownership Interest (100%)
Adp of the SNF
Direct Ownership Interest (100%)		 Oct 23, 1991
Oct 23, 1991
Oct 23, 1991
New York Veterans Home at BataviaBatavia, NY, CCN 335788 Skilled nursing facility 5% Or Greater Direct Ownership Interest (100%)
Operational/Managerial Control (100%)
Adp of the SNF		 Apr 1, 1995
Apr 1, 1995
Apr 1, 1995
New York State Veterans HomeOxford, NY, CCN 335097 Skilled nursing facility 5% Or Greater Direct Ownership Interest (100%)
Operational/Managerial Control (100%)
Adp of the SNF		 Apr 1, 1971
Apr 1, 1971
Apr 1, 1971
Nys Veterans Home at St. AlbansJamaica, NY, CCN 335770 Skilled nursing facility 5% Or Greater Direct Ownership Interest (100%)
Operational/Managerial Control		 Dec 31, 1993
Sep 24, 2009
Helen Hayes HospitalWest Haverstraw, NY, CCN 335873 Skilled nursing facility 5% Or Greater Direct Ownership Interest (100%)
Operational/Managerial Control
Adp of the SNF		 Apr 14, 2016
Aug 10, 2016
Aug 10, 2016
Helen Hayes Hospital RHCFWest Haverstraw, NY, CCN 335823 Skilled nursing facility 5% Or Greater Direct Ownership Interest (100%) Jan 1, 1966

Owned or controlled facilities with NPI records 13

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

View all 13

Practitioners & affiliated clinicians

Practitioners 71

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 71

NPI Registry JSON

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

{
    "created_epoch": "1401840000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1411516800000",
    "number": "1588077994",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "450 CLARKSON AVE",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112032012",
            "telephone_number": "718-270-1000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "470 CLARKSON AVE",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112032012",
            "telephone_number": "718-270-1000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SUNY HEALTH SCIENCE CENTER AT BKLYN",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-06-04",
        "last_updated": "2014-09-24",
        "status": "A",
        "authorized_official_last_name": "MILLER",
        "authorized_official_first_name": "RICHARD",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "718-826-4901"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "261QU0200X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Urgent Care",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "University Hospital of Brooklyn",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Brooklyn, NY

Sources for this page

Verify at the official NPI Registry.