Organization Active NPI

Jodine Pharmaceutical Corp

  • Community/Retail Pharmacy
  • Brooklyn, NY
National Provider Identifier
1790718450
Registry record updated May 22, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Retail PharmacyTaxonomy code 3336C0003X
License
027857 Issued in NY
Legal business name
JODINE PHARMACEUTICAL CORP
Practice address
1127 Broadway
Brooklyn, NY 11221-3001
Phone
(718) 452-3261
Fax
(718) 455-5345
NPI assigned
Jul 8, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 22, 2019

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

Authorized official

Name
Joseph Sidney
Title
Partner
Phone
(718) 452-3261

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacy 333600000X
Community/Retail Pharmacy 3336C0003X 027857 NY Primary

Addresses

Primary practice location

1127 Broadway
Brooklyn, NY 11221-3001

Mailing address

1127 Broadway
Brooklyn, NY 11221-3001
Phone (718) 452-3261

Other identifiers 2

IdentifierTypeStateIssuer
2063679OtherPK
02732754MedicaidNY

Other names 1

  • MISHKIN PHARMACY Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20100930068736 NY DME Supplier - Pharmacy 2769684216 Practice locations: Brooklyn, NY
O20250410000484 NY Part B Supplier - Pharmacy 2769684216 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.

Medicare medical equipment & supply locations

SupplierSuppliesMedicare assignment
Jodine Pharmaceutical Corp1127 Broadway, Brooklyn, NY 11221-3001(718) 452-3261 Epoetin|Immunosuppressive Drugs|Nebulizer Drugs|Oral Anticancer Drugs|Oral Antiemetic Drugs Does not accept assignmentParticipating since Jun 21, 2006

National Provider Directory

National Provider Directory

Locations

1127 Broadway
Brooklyn, NY 11221
Phone (718) 452-3261

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1152316800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1558483200000",
    "number": "1790718450",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1127 BROADWAY",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112213001",
            "telephone_number": "718-452-3261",
            "fax_number": "718-455-5345"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1127 BROADWAY",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112213001",
            "telephone_number": "718-452-3261",
            "fax_number": "718-455-5345"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JODINE PHARMACEUTICAL CORP",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-08",
        "last_updated": "2019-05-22",
        "status": "A",
        "authorized_official_last_name": "SIDNEY",
        "authorized_official_first_name": "JOSEPH",
        "authorized_official_title_or_position": "PARTNER",
        "authorized_official_telephone_number": "718-452-3261"
    },
    "taxonomies": [
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "NY",
            "license": "027857",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2063679",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02732754",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "MISHKIN PHARMACY",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "MISHKIN PHARMACY",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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 May 22, 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.