NPIMap

Organization Active NPI

KB Medical, PLLC

  • Anesthesiology Physician
  • New York, NY
National Provider Identifier
1619482734
Registry record updated Dec 12, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
License
153003 Issued in NY
Legal business name
KB MEDICAL, PLLC
Practice address
157 E 72ND St
New York, NY 10021-4331
Phone
(212) 744-8700
Fax
(212) 249-2421
NPI assigned
Dec 12, 2017
Last updated
Dec 12, 2017By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 12, 2017

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

Authorized official

Name
Dr. Douglas R Birns, MDNPI 1134158488
Title
Partner
Phone
(212) 744-8700

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology Physician 207L00000X 153003 NY Primary

Addresses

Primary practice location

157 E 72ND St
New York, NY 10021-4331

Mailing address

PO Box 270
Massapequa Park, NY 11762-0270
Phone (631) 264-2035

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20180319000047 NY Part B Supplier - Clinic/Group Practice 0345502084 Receives reassigned benefits from 4 practitioners
Practice locations: New York, NY

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 5

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": "1513036800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1513036800000",
    "number": "1619482734",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 270",
            "city": "MASSAPEQUA PARK",
            "state": "NY",
            "postal_code": "117620270",
            "telephone_number": "631-264-2035",
            "fax_number": "631-264-1418"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "157 E 72ND ST",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100214331",
            "telephone_number": "212-744-8700",
            "fax_number": "212-249-2421"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KB MEDICAL, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-12-12",
        "last_updated": "2017-12-12",
        "status": "A",
        "authorized_official_last_name": "BIRNS",
        "authorized_official_first_name": "DOUGLAS",
        "authorized_official_middle_name": "R",
        "authorized_official_title_or_position": "PARTNER",
        "authorized_official_telephone_number": "212-744-8700",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "NY",
            "license": "153003",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 12, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.