NPIMap

Organization Active NPI

MMC University Vascular Surgeons

  • Vascular Surgery Physician
  • Brooklyn, NY
National Provider Identifier
1659484368
Registry record updated Sep 3, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Vascular Surgery PhysicianTaxonomy code 2086S0129X
Legal business name
MMC UNIVERSITY VASCULAR SURGEONS
Practice address
4802 10TH Ave
Brooklyn, NY 11219-2916
Phone
(718) 283-8773
NPI assigned
Aug 16, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 3, 2013

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

Authorized official

Name
Martin Cammer
Title
Director
Phone
(718) 283-8773

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Vascular Surgery PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 2086S0129X Primary

Addresses

Primary practice location

4802 10TH Ave
Brooklyn, NY 11219-2916

Mailing address

PO Box 27368
New York, NY 10087-7368
Phone (718) 283-8773

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040322001464 NY Part B Supplier - Clinic/Group Practice 7810888617 Receives reassigned benefits from 10 practitioners
Practice locations: Brooklyn, NY

National Provider Directory

National Provider Directory

Locations

947 49th St
Rm 102
Brooklyn, NY 11219

3049 Ocean Pkwy
Brooklyn, NY 11235
Phone (718) 265-0005

Practitioners & affiliated clinicians

Practitioners 20

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

View all 20

NPI Registry JSON

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

{
    "created_epoch": "1155686400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1378166400000",
    "number": "1659484368",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 27368",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100877368",
            "telephone_number": "718-283-8773"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4802 10TH AVE",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112192916",
            "telephone_number": "718-283-8773"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MMC UNIVERSITY VASCULAR SURGEONS",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-16",
        "last_updated": "2013-09-03",
        "status": "A",
        "authorized_official_last_name": "CAMMER",
        "authorized_official_first_name": "MARTIN",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "718-283-8773"
    },
    "taxonomies": [
        {
            "code": "2086S0129X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Surgery, Vascular Surgery",
            "state": null,
            "license": null,
            "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 Sep 3, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.