NPIMap

Organization Active NPI

Lutheran Medical Center

  • Primary Care Clinic/Center
  • Brooklyn, NY
National Provider Identifier
1619912052
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Primary Care Clinic/CenterTaxonomy code 261QP2300X
License
129364 Issued in NY
Legal business name
LUTHERAN MEDICAL CENTER
Practice address
812 54TH St
Brooklyn, NY 11220-3209
Phone
(718) 686-2680
Fax
(718) 871-0969
NPI assigned
Jun 19, 2006
Last updated
Aug 22, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Dr. Paul Lee
Title
M.D/Attending Physician
Phone
(718) 686-2680

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Primary Care Clinic/Center 261QP2300X 129364 NY Primary

Addresses

Primary practice location

812 54TH St
Brooklyn, NY 11220-3209

Mailing address

812 54TH St
Brooklyn, NY 11220-3209

National Provider Directory

National Provider Directory

Locations

812 54th St
Brooklyn, NY 11220
Phone (718) 686-2680

Practitioners & affiliated clinicians

Practitioners 10

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": "1150675200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1619912052",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "812 54TH ST",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112203209"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "812 54TH ST",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112203209",
            "telephone_number": "718-686-2680",
            "fax_number": "718-871-0969"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LUTHERAN MEDICAL CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-19",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "LEE",
        "authorized_official_first_name": "PAUL",
        "authorized_official_title_or_position": "M.D/ATTENDING PHYSICIAN",
        "authorized_official_telephone_number": "718-686-2680",
        "authorized_official_name_prefix": "Dr."
    },
    "taxonomies": [
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": "NY",
            "license": "129364",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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 Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.