NPIMap

Organization Active NPI

Central Brooklyn Medical Group

  • Health Maintenance Organization
  • Brooklyn, NY
National Provider Identifier
1821414780
Registry record updated Mar 14, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Health Maintenance OrganizationTaxonomy code 302R00000X
Legal business name
CENTRAL BROOKLYN MEDICAL GROUP
Practice address
477 Atlantic Ave
Brooklyn, NY 11217-2981
Phone
(718) 403-3567
Fax
(718) 403-3548
NPI assigned
Mar 14, 2014
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 14, 2014

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

Authorized official

Name
Dr. Lesly Kernisant, MD
Title
Executive Director of Clinical Prac
Phone
(718) 422-8030

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Health Maintenance Organization 302R00000X Primary

Addresses

Primary practice location

477 Atlantic Ave
Brooklyn, NY 11217-2981

Mailing address

477 Atlantic Ave
Brooklyn, NY 11217-2981
Phone (718) 403-3567

Other names 1

  • Preferred health Partners Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Central Brooklyn Medical Group6 organizations share this tax ID, including this one

Other organizations with this tax ID 5

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

NPI Registry JSON

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

{
    "created_epoch": "1394755200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1394755200000",
    "number": "1821414780",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "477 ATLANTIC AVE",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112172981",
            "telephone_number": "718-403-3567",
            "fax_number": "718-403-3548"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "477 ATLANTIC AVE",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112172981",
            "telephone_number": "718-403-3567",
            "fax_number": "718-403-3548"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CENTRAL BROOKLYN MEDICAL GROUP",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-03-14",
        "last_updated": "2014-03-14",
        "status": "A",
        "authorized_official_last_name": "KERNISANT",
        "authorized_official_first_name": "LESLY",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR OF CLINICAL PRAC",
        "authorized_official_telephone_number": "718-422-8030",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "302R00000X",
            "taxonomy_group": "",
            "desc": "Health Maintenance Organization",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Preferred health Partners",
            "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 Mar 14, 2014; 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.