Individual provider Active NPI

Boris Beytelman

  • Specialist
  • Brooklyn, NY
National Provider Identifier
1689977985
Registry record updated Jun 28, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
Practice address
2563 Hubbard St # 1-F
Brooklyn, NY 11235-6222
Phone
(718) 891-8873
Fax
(718) 891-8873
NPI assigned
Dec 9, 2010
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 28, 2012

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X 738770 NY
Specialist 174400000X Primary

Addresses

Primary practice location

2563 Hubbard St # 1-F
Brooklyn, NY 11235-6222

Mailing address

2563 Hubbard St # 1-F
Brooklyn, NY 11235-6222
Phone (718) 891-8873

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
738770NYMDStudent in an Organized Health Care Education/Training Program

NPI Registry JSON

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

{
    "created_epoch": "1291852800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1340841600000",
    "number": "1689977985",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2563 HUBBARD ST # 1-F",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112356222",
            "telephone_number": "718-891-8873",
            "fax_number": "718-891-8873"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2563 HUBBARD ST # 1-F",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112356222",
            "telephone_number": "718-891-8873",
            "fax_number": "718-891-8873"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BEYTELMAN",
        "first_name": "BORIS",
        "name_prefix": "Mr.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2010-12-09",
        "last_updated": "2012-06-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "NY",
            "license": "738770",
            "primary": false
        },
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "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 Jun 28, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.