Organization Active NPI

Prestige Care Pharmacy Inc

  • Community/Retail Pharmacy
  • Brooklyn, NY
National Provider Identifier
1679850689
Registry record updated Apr 5, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Retail PharmacyTaxonomy code 3336C0003X
License
030978 Issued in NY
Legal business name
PRESTIGE CARE PHARMACY INC
Doing business as
Prestige Care Pharmacy, Inc
Practice address
1190 Gravesend Neck Rd
Brooklyn, NY 11229-4208
Phone
(718) 676-6691
Fax
(718) 676-6694
NPI assigned
Nov 5, 2011
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 5, 2017

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

Authorized official

Name
Dmitriy ShapiroNPI 1689951691
Title
President
Phone
(646) 643-3208

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 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacy 333600000X
Community/Retail Pharmacy 3336C0003X 030978 NY Primary

Addresses

Primary practice location

1190 Gravesend Neck Rd
Brooklyn, NY 11229-4208

Mailing address

1190 Gravesend Neck Rd
Brooklyn, NY 11229-4208
Phone (718) 676-6691

Other identifiers 1

IdentifierTypeStateIssuer
2132589OtherPK

Other names 1

  • Prestige Care Pharmacy, Inc Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20120516000252 NY DME Supplier - Pharmacy 4284897976 Practice locations: Brooklyn, NY
O20230215002154 NY Part B Supplier - Pharmacy 4284897976 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.

Medicare medical equipment & supply locations

SupplierSuppliesMedicare assignment
Prestige Care Pharmacy Inc1190 Gravesend Neck Rd, Brooklyn, NY 11229-4208(718) 676-6691 Epoetin|Immunosuppressive Drugs|Infusion Drugs|Nebulizer Drugs|Oral Anticancer Drugs|Oral Antiemetic Drugs|Blood Glucose Monitors/Supplies (Non-Mail Order)|Canes and/or Crutches|Orthoses: Prefabricated (Non-Custom Fabricated)|Orthoses: Off-The-Shelf|Surgical Dressings|Diabetic Shoes and Inserts Does not accept assignmentParticipating since Mar 19, 2012

National Provider Directory

National Provider Directory

Locations

1190 Gravesend Neck Rd
Brooklyn, NY 11229
Phone (646) 643-3208

Practitioners & affiliated clinicians

Practitioners 1

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": "1320451200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1491350400000",
    "number": "1679850689",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1190 GRAVESEND NECK RD",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112294208",
            "telephone_number": "718-676-6691",
            "fax_number": "718-676-6694"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1190 GRAVESEND NECK RD",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112294208",
            "telephone_number": "718-676-6691",
            "fax_number": "718-676-6694"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PRESTIGE CARE PHARMACY INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-11-05",
        "last_updated": "2017-04-05",
        "status": "A",
        "authorized_official_last_name": "SHAPIRO",
        "authorized_official_first_name": "DMITRIY",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "646-643-3208"
    },
    "taxonomies": [
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "NY",
            "license": "030978",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2132589",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Prestige Care Pharmacy, Inc",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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 Apr 5, 2017; 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.