NPIMap

Organization Active NPI

Maimonides Medical Center - MMC Division of Geriatric Medicine FPP

  • Geriatric Medicine (Internal Medicine) Physician
  • Brooklyn, NY
National Provider Identifier
1831203132
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Geriatric Medicine (Internal Medicine) PhysicianTaxonomy code 207RG0300X
Legal business name
MAIMONIDES MEDICAL CENTER - MMC DIVISION OF GERIATRIC MEDICINE FPP
Practice address
4802 10TH Ave
Brooklyn, NY 11219-2916
Phone
(718) 283-8773
NPI assigned
Aug 17, 2006
Last updated
Aug 22, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Barbara Paris, MD
Title
Division Head
Phone
(718) 283-8773

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Geriatric Medicine (Internal Medicine) Physician 207RG0300X NU Primary

Addresses

Primary practice location

4802 10TH Ave
Brooklyn, NY 11219-2916

Mailing address

Gpo Box 27634
New York, NY 10087-7634

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20080925000245 NY Part B Supplier - Clinic/Group Practice 9739256223 Receives reassigned benefits from 12 practitioners
Practice locations: Brooklyn, NY

National Provider Directory

National Provider Directory

Locations

4719 Fort Hamilton Pkwy
Brooklyn, NY 11219
Phone (718) 283-7089

Practitioners & affiliated clinicians

Practitioners 16

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 16

NPI Registry JSON

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

{
    "created_epoch": "1155772800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1831203132",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "GPO BOX 27634",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100877634"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4802 10TH AVE",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112192916",
            "telephone_number": "718-283-8773"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MAIMONIDES MEDICAL CENTER - MMC DIVISION OF GERIATRIC MEDICINE FPP",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-17",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "PARIS",
        "authorized_official_first_name": "BARBARA",
        "authorized_official_title_or_position": "DIVISION HEAD",
        "authorized_official_telephone_number": "718-283-8773",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207RG0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Geriatric Medicine",
            "state": "NU",
            "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 Aug 22, 2020; 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.