Individual provider Active NPI

Seyed Hosayn Heydarpour, M..D.

  • Pediatrics Physician
  • Brooklyn, NY
National Provider Identifier
1720164452
Registry record updated Dec 30, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
224734 Issued in NY
Practice address
1456 Fulton St
Brooklyn, NY 11216-2505
Phone
(718) 636-4500
Fax
(347) 296-8337
NPI assigned
Oct 27, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 30, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 224734 NY Primary

Addresses

Primary practice location

1456 Fulton St
Brooklyn, NY 11216-2505

Mailing address

1456 Fulton St
Brooklyn, NY 11216-2505
Phone (718) 636-4500

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20200928000138 NY Order and Referring Only - Pediatric MedicinePractitioner - Pediatric Medicine 8729261698

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
224734NYMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Peninsula Medical Services PC Pediatrics Past Accepting new patients

Organizations & group practices 1

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

NPI Registry JSON

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

{
    "created_epoch": "1161907200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1451433600000",
    "number": "1720164452",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1456 FULTON ST",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112162505",
            "telephone_number": "718-636-4500",
            "fax_number": "347-296-8337"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1456 FULTON ST",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112162505",
            "telephone_number": "718-636-4500",
            "fax_number": "347-296-8337"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HEYDARPOUR",
        "first_name": "SEYED",
        "middle_name": "HOSAYN",
        "credential": "M..D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-27",
        "last_updated": "2015-12-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "NY",
            "license": "224734",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brooklyn, NY

Sources for this page

Verify at the official NPI Registry.