NPIMap

Individual provider Active NPI

Marwan Atallah

  • Urology Physician
  • Brooklyn, NY
National Provider Identifier
1649227091
Registry record updated Apr 10, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Urology PhysicianTaxonomy code 208800000X
License
128270 Issued in NY
Practice address
142 Joralemon St
Brooklyn, NY 11201-4709
Phone
(718) 643-9371
NPI assigned
May 30, 2006
Last updated
Apr 10, 2008By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 10, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Urology Physician 208800000X 128270 NY Primary

Addresses

Primary practice location

142 Joralemon St
Brooklyn, NY 11201-4709

Mailing address

PO Box 117
Brooklyn, NY 11228-0117

Other identifiers 1

IdentifierTypeStateIssuer
00247232MedicaidNY

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20060719000106 NY Practitioner - Urology 4789697681 Reassigns benefits to 5 organizations

Care Compare profile

Medicare Care Compare
Specialty
Urology
Education
Other, 1971
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Maimonides Urology FPPGroup PAC ID 3870766686, 17 clinicians

Practice addresses (Care Compare)

4802 10TH Ave
Brooklyn, NY 11219-2916
Phone (718) 283-7746

7901 Broadway
Elmhurst, NY 11373-1329

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Maimonides Faculty Practice Plan CurrentSince Nov 1, 2024 Accepting new patients
Maimonides Medical Center Current Accepting new patients
Dimitri N Kessaris MDPC Urology CurrentSince Aug 1, 2022 Accepting new patients
Icahn School of Medicine at Mount Sinai Urology CurrentSince Feb 6, 2025 Accepting new patients
Icahn School of Medicine at Mount Sinai CurrentSince Feb 6, 2025 Accepting new patients
Maimonides Urology FPP Urology CurrentSince Nov 1, 2024 Accepting new patients
Icahn School of Medicine at Mount Sinai Urology CurrentSince Sep 1, 2023 Accepting new patients
Icahn School of Medicine at Mount Sinai CurrentSince Sep 1, 2023 Accepting new patients

Locations

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

7210 13th Ave
Fl 2
Brooklyn, NY 11228
Phone (718) 439-2388

7901 Broadway
Rm A119
Elmhurst, NY 11373
Phone (718) 334-4951

6902 Austin St
Forest Hills, NY 11375
Phone (516) 423-6141

315 E Shore Rd
Manhasset, NY 11030
Phone (516) 773-6611

5 E 98th St
Fl 5
New York, NY 10029
Phone (212) 241-8234

Networks

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

Interoperability endpoints

  • Direct secure messaging: marwanatallah@mai.allscriptsdirect.net
  • Direct secure messaging: matallah5588241@nychhc.direct-ci.com

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.

Hospital & facility affiliations 3

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1148947200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1207785600000",
    "number": "1649227091",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 117",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112280117"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "142 JORALEMON ST",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112014709",
            "telephone_number": "718-643-9371"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ATALLAH",
        "first_name": "MARWAN",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-05-30",
        "last_updated": "2008-04-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208800000X",
            "taxonomy_group": "",
            "desc": "Urology",
            "state": "NY",
            "license": "128270",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00247232",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Brooklyn, NY

Sources for this page

Verify at the official NPI Registry.