Individual provider Active NPI

Jean K Auguste, M.D.,

  • Internal Medicine Physician
  • Brooklyn, NY
National Provider Identifier
1730290354
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
153908 Issued in NY
Practice address
134 Van Dyke St
Brooklyn, NY 11231-1012
Phone
(718) 802-1111
Fax
(718) 802-9013
NPI assigned
Aug 31, 2006
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 153908 NY Primary

Addresses

Primary practice location

134 Van Dyke St
Brooklyn, NY 11231-1012

Mailing address

14 Buffalo St
Elmont, NY 11003-5015
Phone (718) 802-1111

Other identifiers 1

IdentifierTypeStateIssuer
153918MedicaidNY

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)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
153908NYMDHematology & Oncology Physician

NPI Registry JSON

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

{
    "created_epoch": "1156982400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1730290354",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14 BUFFALO ST",
            "city": "ELMONT",
            "state": "NY",
            "postal_code": "110035015",
            "telephone_number": "718-802-1111"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "134 VAN DYKE ST",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112311012",
            "telephone_number": "718-802-1111",
            "fax_number": "718-802-9013"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "AUGUSTE",
        "first_name": "JEAN",
        "middle_name": "K",
        "name_prefix": "Dr.",
        "credential": "M.D.,",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-08-31",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NY",
            "license": "153908",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "153918",
            "state": "NY"
        }
    ],
    "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 Jul 8, 2007; 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.