NPIMap

Organization Active NPI

Boro Park Medical P.C.

  • Internal Medicine Physician
  • Brooklyn, NY
National Provider Identifier
1790815736
Registry record updated Feb 24, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
189657 Issued in NY
Legal business name
BORO PARK MEDICAL P.C.
Practice address
1379 54TH St
Brooklyn, NY 11219-4259
Phone
(718) 436-1600
Fax
(718) 436-2085
NPI assigned
Mar 7, 2007
Last updated
Feb 24, 2010By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 24, 2010

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

Authorized official

Name
Dr. Josif Sholomon, M.D.NPI 1548261811
Title
Owner
Phone
(718) 436-1600

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 189657 NY Primary

Addresses

Primary practice location

1379 54TH St
Brooklyn, NY 11219-4259

Mailing address

1379 54TH St
Brooklyn, NY 11219-4259
Phone (718) 436-1600

Other identifiers 3

IdentifierTypeStateIssuer
02559608MedicaidNY
7218155OtherNYAETNA
2596135OtherNYGHI

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20031215000605 NY Part B Supplier - Clinic/Group Practice 5395642714 Receives reassigned benefits from 9 practitioners
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.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
33D0714560Boro Park Medical PC1379 54TH Street, Brooklyn, NY 11219ComplianceJul 31, 2026

National Provider Directory

National Provider Directory

Locations

1379 54th St
Ste 1
Brooklyn, NY 11219
Phone (718) 436-1600

Practitioners & affiliated clinicians

Practitioners 24

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.

View all 24

NPI Registry JSON

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

{
    "created_epoch": "1173225600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1266969600000",
    "number": "1790815736",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1379 54TH ST",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112194259",
            "telephone_number": "718-436-1600",
            "fax_number": "718-436-2085"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1379 54TH ST",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112194259",
            "telephone_number": "718-436-1600",
            "fax_number": "718-436-2085"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BORO PARK MEDICAL P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-07",
        "last_updated": "2010-02-24",
        "status": "A",
        "authorized_official_last_name": "SHOLOMON",
        "authorized_official_first_name": "JOSIF",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "718-436-1600",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NY",
            "license": "189657",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02559608",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "7218155",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GHI",
            "identifier": "2596135",
            "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 Feb 24, 2010; 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.