Organization Active NPI

Simon F Medical Services PC

  • Family Medicine Physician
  • Brooklyn, NY
National Provider Identifier
1780233569
Registry record updated Feb 15, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
SIMON F MEDICAL SERVICES PC
Practice address
250 Skillman St Ste 204
Brooklyn, NY 11205-1218
Phone
(718) 964-6161
NPI assigned
Sep 5, 2019
Last updated
Feb 15, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 15, 2023

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

Authorized official

Name
Brooke Lichtenstein
Title
MD
Phone
(212) 734-6621

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X Primary

Addresses

Primary practice location

250 Skillman St Ste 204
Brooklyn, NY 11205-1218

Mailing address

250 Skillman St Ste 204
Brooklyn, NY 11205-1218
Phone (212) 734-6621

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY, SC2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20191010001983 NY Part B Supplier - Clinic/Group Practice 8820329527 Receives reassigned benefits from 1 practitioner
Practice locations: New York, NY
O20241205004215 SC Part B Supplier - Clinic/Group Practice 8820329527 Receives reassigned benefits from 1 practitioner
Practice locations: Mayesville, SC

National Provider Directory

National Provider Directory
Tax ID family
Simon F Medical Services2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Locations

104 W 145th St
New York, NY 10039

Practitioners & affiliated clinicians

Practitioners 1

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": "1567641600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1676419200000",
    "number": "1780233569",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "250 SKILLMAN ST STE 204",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112051218",
            "telephone_number": "212-734-6621"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "250 SKILLMAN ST STE 204",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112051218",
            "telephone_number": "718-964-6161"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SIMON F MEDICAL SERVICES PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-09-05",
        "last_updated": "2023-02-15",
        "certification_date": "2023-02-15",
        "status": "A",
        "authorized_official_last_name": "LICHTENSTEIN",
        "authorized_official_first_name": "BROOKE",
        "authorized_official_title_or_position": "MD",
        "authorized_official_telephone_number": "212-734-6621"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "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 Feb 15, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.