Individual provider Active NPI

Vitaly Kramer, PA-C

  • Physician Assistant
  • Brooklyn, NY
National Provider Identifier
1649672650
Registry record updated May 7, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
017756 Issued in NY
Practice address
7901 4TH Ave Ste A20
Brooklyn, NY 11209-3957
Phone
(718) 491-5800
NPI assigned
Sep 22, 2014
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 7, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 017756 NY Primary

Addresses

Primary practice location

7901 4TH Ave Ste A20
Brooklyn, NY 11209-3957

Mailing address

161 18TH St Apt 2R
Brooklyn, NY 11215-8300
Phone (716) 830-0847

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20180330000022 NY Practitioner - Physician Assistant 2961764048 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Saitta Dermatology PC CurrentSince May 9, 2021 Accepting new patients
Live Beyond Medical MGMT LLC PastSince Mar 21, 2021 Accepting new patients
Derm Specs of PA PLLC PastSince Feb 25, 2024 Accepting new patients
Siny Dermatology Florida PastSince Mar 24, 2024 Accepting new patients

Locations

7901 4th Ave
Ste A20
Brooklyn, NY 11209
Phone (718) 491-6900

438 Graham Ave
Brooklyn, NY 11211
Phone (718) 349-5912

76 7th Ave
Brooklyn, NY 11217
Phone (718) 238-0500

10933 71st Rd
Ste 1F
Forest Hills, NY 11375
Phone (718) 575-2930

69 E 76th St
New York, NY 10021
Phone (212) 288-7231

Networks

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

Organizations & group practices 5

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1411344000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1620345600000",
    "number": "1649672650",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "161 18TH ST APT 2R",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112158300",
            "telephone_number": "716-830-0847"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7901 4TH AVE STE A20",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112093957",
            "telephone_number": "718-491-5800"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KRAMER",
        "first_name": "VITALY",
        "name_prefix": "Mr.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-09-22",
        "last_updated": "2021-05-07",
        "certification_date": "2021-05-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NY",
            "license": "017756",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brooklyn, NY

Sources for this page

Verify at the official NPI Registry.