Organization Active NPI

Advanced Medical Group PC

  • Pulmonary Disease Physician
  • Brooklyn, NY
National Provider Identifier
1710939798
Registry record updated Aug 20, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pulmonary Disease PhysicianTaxonomy code 207RP1001X
Legal business name
ADVANCED MEDICAL GROUP PC
Practice address
1958 Ocean Ave
Brooklyn, NY 11230-6719
Phone
(718) 645-8901
Fax
(718) 645-7970
NPI assigned
May 17, 2006
Last updated
Aug 20, 2019By the provider in NPPES
Organization subpart
Yes
Parent organization
ADVANCED MEDICAL GROUP P.C.As reported in NPPES

NPPES NPI Registry

Updated by the provider on Aug 20, 2019

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

Authorized official

Name
Dr. Reuven MoshenyatNPI 1598719585
Title
President
Phone
(718) 645-8901

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
Gastroenterology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207RG0100X
Pulmonary Disease PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207RP1001X Primary

Addresses

Primary practice location

1958 Ocean Ave
Brooklyn, NY 11230-6719

Mailing address

1958 Ocean Ave
Brooklyn, NY 11230-6719
Phone (718) 645-8901

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20060623000177 NY Part B Supplier - Clinic/Group Practice 9739191339 Receives reassigned benefits from 7 practitioners
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
33D1043941Advanced Medical Group PC1958 Ocean Avenue, Brooklyn, NY 11230ComplianceJul 31, 2026

National Provider Directory

National Provider Directory
Part of
Advanced Medical Group PC

Practitioners & affiliated clinicians

Practitioners 10

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1147824000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1566259200000",
    "number": "1710939798",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1958 OCEAN AVE",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112306719",
            "telephone_number": "718-645-8901",
            "fax_number": "718-645-7970"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1958 OCEAN AVE",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112306719",
            "telephone_number": "718-645-8901",
            "fax_number": "718-645-7970"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ADVANCED MEDICAL GROUP PC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "ADVANCED MEDICAL GROUP P.C.",
        "enumeration_date": "2006-05-17",
        "last_updated": "2019-08-20",
        "status": "A",
        "authorized_official_last_name": "MOSHENYAT",
        "authorized_official_first_name": "REUVEN",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "718-645-8901",
        "authorized_official_name_prefix": "Dr."
    },
    "taxonomies": [
        {
            "code": "207RG0100X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine, Gastroenterology",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207RP1001X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine, Pulmonary Disease",
            "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 Aug 20, 2019; 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.