NPIMap

Organization Active NPI

The Brookdale Hospital Medical Center

  • End-Stage Renal Disease (ESRD) Treatment Clinic/Center
  • Brooklyn, NY
National Provider Identifier
1689849952
Registry record updated Nov 15, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
End-Stage Renal Disease (ESRD) Treatment Clinic/CenterTaxonomy code 261QE0700X
Legal business name
THE BROOKDALE HOSPITAL MEDICAL CENTER
Practice address
585 Schenectady Ave
Brooklyn, NY 11203-1851
Phone
(718) 604-5532
Fax
(718) 604-5527
NPI assigned
Apr 28, 2008
Last updated
Nov 15, 2024By the provider in NPPES
Organization subpart
Yes
Parent organization
BROOKDALE HOSPITAL MEDICAL CENTERAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Nov 15, 2024

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

Authorized official

Name
Charles Salvo
Title
Senior Vice President
Phone
(718) 240-6374

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
End-Stage Renal Disease (ESRD) Treatment Clinic/Center 261QE0700X 7001033H NY
End-Stage Renal Disease (ESRD) Treatment Clinic/Center 261QE0700X NU Primary

Addresses

Primary practice location

585 Schenectady Ave
Brooklyn, NY 11203-1851

Mailing address

10101 Avenue D
Kingsbrook Jewish Medical Center
Brooklyn, NY 11236-1902
Phone (718) 240-8534

Other identifiers 1

IdentifierTypeStateIssuer
2998763MedicaidNY

Other names 1

  • Acute Renal Dialysis Former legal business name

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20210401002153 NY Part A Provider - End-Stage Renal Disease Facility (ESRD) 4284545799 Practice locations: Brooklyn, NY

Other NPIs with the same Medicare PAC ID 7

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

National Provider Directory

National Provider Directory
Part of
Michael G Mendelsohn

NPI Registry JSON

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

{
    "created_epoch": "1209340800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1731628800000",
    "number": "1689849952",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10101 AVENUE D",
            "address_2": "KINGSBROOK JEWISH MEDICAL CENTER",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112361902",
            "telephone_number": "718-240-8534",
            "fax_number": "718-240-6492"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "585 SCHENECTADY AVE",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112031851",
            "telephone_number": "718-604-5532",
            "fax_number": "718-604-5527"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "THE BROOKDALE HOSPITAL MEDICAL CENTER",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "BROOKDALE HOSPITAL MEDICAL CENTER",
        "enumeration_date": "2008-04-28",
        "last_updated": "2024-11-15",
        "certification_date": "2024-11-13",
        "status": "A",
        "authorized_official_last_name": "SALVO",
        "authorized_official_first_name": "CHARLES",
        "authorized_official_title_or_position": "SENIOR VICE PRESIDENT",
        "authorized_official_telephone_number": "718-240-6374"
    },
    "taxonomies": [
        {
            "code": "261QE0700X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, End-Stage Renal Disease (ESRD) Treatment",
            "state": "NY",
            "license": "7001033H",
            "primary": false
        },
        {
            "code": "261QE0700X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, End-Stage Renal Disease (ESRD) Treatment",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2998763",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Acute Renal Dialysis",
            "code": "4",
            "type": "Former Legal Business Name"
        },
        {
            "organization_name": "Acute Renal Dialysis",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

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 Nov 15, 2024; 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.