Organization Active NPI

Urban Family Doctor, PLLC

  • Family Medicine Physician
  • Brooklyn, NY
National Provider Identifier
1710535836
Registry record updated May 9, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
URBAN FAMILY DOCTOR, PLLC
Practice address
185 Ocean Ave # 1a
Brooklyn, NY 11225-4763
Phone
(347) 669-0017
Fax
(347) 669-0016
NPI assigned
Sep 2, 2019
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 9, 2025

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

Authorized official

Name
Amanda HarrisNPI 1861759623
Title
Sole Owner
Phone
(347) 669-0017

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
Family Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207Q00000X Primary

Addresses

Primary practice location

185 Ocean Ave # 1a
Brooklyn, NY 11225-4763

Mailing address

185 Ocean Ave # 1a
Brooklyn, NY 11225-4763
Phone (347) 669-0017

Other identifiers 1

IdentifierTypeStateIssuer
04658779MedicaidNY

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address Amanda.Harris@263390393729028.direct.elationemr.com Direct

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20191018000277 NY Part B Supplier - Clinic/Group Practice 8628309929 Receives reassigned benefits from 1 practitioner
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
33D2171779Urban Family Doctor, PLLC185 Ocean Avenue - #1a, Brooklyn, NY 11225Certificate of waiverSep 9, 2027

National Provider Directory

National Provider Directory

Interoperability endpoints

  • Direct secure messaging: amanda.harris@263390393729028.direct.elationemr.com

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": "1567382400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1746748800000",
    "number": "1710535836",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "185 OCEAN AVE # 1A",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112254763",
            "telephone_number": "347-669-0017"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "185 OCEAN AVE # 1A",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112254763",
            "telephone_number": "347-669-0017",
            "fax_number": "347-669-0016"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "URBAN FAMILY DOCTOR, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-09-02",
        "last_updated": "2025-05-09",
        "certification_date": "2025-05-09",
        "status": "A",
        "authorized_official_last_name": "HARRIS",
        "authorized_official_first_name": "AMANDA",
        "authorized_official_title_or_position": "SOLE OWNER",
        "authorized_official_telephone_number": "347-669-0017"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "04658779",
            "state": "NY"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "Amanda.Harris@263390393729028.direct.elationemr.com",
            "affiliation": "N",
            "endpointDescription": "Direct Address",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "185 Ocean Ave # 1A",
            "city": "Brooklyn",
            "state": "NY",
            "country_code": "US",
            "postal_code": "112254763",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "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 May 9, 2025; 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.