Individual provider Active NPI

Mounzer Tchelebi, MD

  • Radiation Oncology Physician
  • Brooklyn, NY
National Provider Identifier
1639152960
Registry record updated Nov 19, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Radiation Oncology PhysicianTaxonomy code 2085R0001X
License
1609011 Issued in NY
Practice address
374 Stockholm St
Suite C 08
Brooklyn, NY 11237-4006
Phone
(718) 963-7381
Fax
(718) 963-7744
NPI assigned
Nov 21, 2005
Last updated
Nov 19, 2011By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 19, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Radiation Oncology Physician 2085R0001X 1609011 NY Primary

Addresses

Primary practice location

374 Stockholm St
Suite C 08
Brooklyn, NY 11237-4006

Mailing address

374 Stockholm Street
Suite C 08
Brooklyn, NY 11237
Phone (718) 963-7381

Other identifiers 1

IdentifierTypeStateIssuer
00980974MedicaidNY

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
I20040323000931 NY Practitioner - Radiation Oncology 6406747005 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Radiation Oncology
Education
Other, 1977
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

374 Stockholm St
Suite C08
Brooklyn, NY 11237-4006
Phone (718) 963-7381

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
1609011NYMDRadiation Oncology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Kings Physician Services, PC Radiation Oncology CurrentSince Aug 1, 2015 Accepting new patients
Kings Physician Services, PC CurrentSince Aug 1, 2015 Accepting new patients
Coney Island Medical Practice Plan, P.C. CurrentSince Mar 1, 2020 Accepting new patients
Tma, LLC Radiation Oncology CurrentSince Mar 1, 2008 Accepting new patients
Wyckoff Heights Medical Center Current Accepting new patients
Brooklyn Radiation Oncology PC Radiation Oncology Past Accepting new patients
University Group Medical Associates, P.C Past Accepting new patients
Cutting Edge Pet/CF and Imaging PLLC Past Accepting new patients

Locations

2601 Ocean Pkwy
Brooklyn, NY 11235
Phone (718) 616-5354

2601 Ocean Pkwy
#D
Brooklyn, NY 11235
Phone (718) 769-5158

374 Stockholm St
Brooklyn, NY 11237
Phone (718) 963-6485

374 Stockholm St
#C8
Brooklyn, NY 11237
Phone (718) 963-7381

374 Stockholm St
Ste C
Brooklyn, NY 11237
Phone (718) 963-7381

374 Stockholm St
Ste C8
Brooklyn, NY 11237
Phone (718) 963-7381

506 6th St
Brooklyn, NY 11215
Phone (718) 780-3279

506 6th St
Ste B
Brooklyn, NY 11215
Phone (718) 780-3677

Networks

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

Interoperability endpoints

  • Direct secure messaging: mounzertchelebi@whmc.allscriptsdirect.net

Ownership & related parties

All facility ownership & control disclosures 1

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

FacilityTypeRoleSince
Wyckoff Heights Medical CenterBrooklyn, NY, CCN 330221 Hospital Corporate Director Aug 1, 2013

Owned or controlled facilities with NPI records 1

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

Organizations & group practices 9

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": "1132531200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1321660800000",
    "number": "1639152960",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "374 STOCKHOLM STREET",
            "address_2": "SUITE C 08",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "11237",
            "telephone_number": "718-963-7381",
            "fax_number": "718-963-7744"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "374 STOCKHOLM ST",
            "address_2": "SUITE C 08",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112374006",
            "telephone_number": "718-963-7381",
            "fax_number": "718-963-7744"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TCHELEBI",
        "first_name": "MOUNZER",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-11-21",
        "last_updated": "2011-11-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0001X",
            "taxonomy_group": "",
            "desc": "Radiology, Radiation Oncology",
            "state": "NY",
            "license": "1609011",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00980974",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Brooklyn, NY

Sources for this page

Verify at the official NPI Registry.