NPIMap

Individual provider Active NPI

Michael Tavdy, M.D.

  • Internal Medicine Physician
  • Brooklyn, NY
National Provider Identifier
1720016793
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
221582 Issued in NY
Practice address
2705 Mermaid Ave
Brooklyn, NY 11224-2005
Phone
(718) 265-2222
Fax
(718) 333-1023
NPI assigned
Jun 29, 2006
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 221582 NY Primary

Addresses

Primary practice location

2705 Mermaid Ave
Brooklyn, NY 11224-2005

Mailing address

6636 Yellowstone Blvd Apt 8H
Forest Hills, NY 11375-2552
Phone (718) 997-1722

Other identifiers 1

IdentifierTypeStateIssuer
02160254MedicaidNY

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20041012000254 NY Practitioner - Internal Medicine 0042270480 Reassigns benefits to 1 organization
Practice locations: Brooklyn, NY

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 1980
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
South Brooklyn Medical Care PCGroup PAC ID 6002844933, 4 clinicians

Practice addresses (Care Compare)

2705 Mermaid Ave
Brooklyn, NY 11224-2005
Phone (718) 265-2222

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
46.2 of 100Reported as individual
Quality
25
Improvement activities
0
Cost
87.34

Procedures performed for Medicare patients

ProcedureNumber of procedures
Melanoma (skin cancer) excision1-10
Removal of tissue1-10
Removal of nail tissue1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Maimonides Medical Center Current Accepting new patients
South Brooklyn Medical Care, PC Internal Medicine CurrentSince May 1, 2005 Accepting new patients
New York City Health and Hospitals Corporation Internal Medicine Past Accepting new patients

Locations

2705 Mermaid Ave
Brooklyn, NY 11224
Phone (718) 265-2222

Networks

  • Healthfirst Medicare Network H5989
  • Healthfirst Medicare Network H1722
  • Healthfirst Medicare Network H9678
  • Healthfirst Medicare Network H3359

Interoperability endpoints

  • Direct secure messaging: michaeltavdy@mai.allscriptsdirect.net

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 5

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1151539200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1720016793",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6636 YELLOWSTONE BLVD APT 8H",
            "city": "FOREST HILLS",
            "state": "NY",
            "postal_code": "113752552",
            "telephone_number": "718-997-1722",
            "fax_number": "718-333-1023"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2705 MERMAID AVE",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112242005",
            "telephone_number": "718-265-2222",
            "fax_number": "718-333-1023"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TAVDY",
        "first_name": "MICHAEL",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-06-29",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NY",
            "license": "221582",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02160254",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Brooklyn, NY

Sources for this page

Verify at the official NPI Registry.