Organization Active NPI

Kensington Pediatrics, PC

  • Legal Medicine
  • Brooklyn, NY
National Provider Identifier
1659346682
Registry record updated Aug 13, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Legal MedicineTaxonomy code 173000000X
License
146343 Issued in NY
Legal business name
KENSINGTON PEDIATRICS, PC
Practice address
3904 16TH Ave
Brooklyn, NY 11218-5500
Phone
(718) 435-1449
NPI assigned
Feb 22, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 13, 2019

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

Authorized official

Name
Max BulmashNPI 1215902242
Title
Director Officer
Phone
(718) 851-8080

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
Legal MedicineGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 173000000X 146343 NY Primary

Addresses

Primary practice location

3904 16TH Ave
Brooklyn, NY 11218-5500

Mailing address

PO Box 190421
Brooklyn, NY 11219-0421

Other identifiers 1

IdentifierTypeStateIssuer
00787302MedicaidNY

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20060426000334 NY Part B Supplier - Clinic/Group Practice 0446260186 Receives reassigned benefits from 2 practitioners
Practice locations: Brooklyn, NY

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
33D0164502Kensington Pediatrics PC3904 16TH Avenue, Brooklyn, NY 11218ComplianceDec 25, 2026

National Provider Directory

National Provider Directory

Locations

3904 16th Ave
Brooklyn, NY 11218
Phone (718) 435-1449

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1140566400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1565654400000",
    "number": "1659346682",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 190421",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112190421"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3904 16TH AVE",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112185500",
            "telephone_number": "718-435-1449"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KENSINGTON PEDIATRICS, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-02-22",
        "last_updated": "2019-08-13",
        "status": "A",
        "authorized_official_last_name": "BULMASH",
        "authorized_official_first_name": "MAX",
        "authorized_official_title_or_position": "DIRECTOR OFFICER",
        "authorized_official_telephone_number": "718-851-8080"
    },
    "taxonomies": [
        {
            "code": "173000000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Legal Medicine",
            "state": "NY",
            "license": "146343",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00787302",
            "state": "NY"
        }
    ],
    "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 13, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.