Organization Active NPI

Nyc Medical Doctor P.C.

  • Geriatric Medicine (Internal Medicine) Physician
  • Brooklyn, NY
National Provider Identifier
1831489798
Registry record updated Mar 7, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Geriatric Medicine (Internal Medicine) PhysicianTaxonomy code 207RG0300X
License
215006 Issued in NY
Legal business name
NYC MEDICAL DOCTOR P.C.
Practice address
699 Stanley Ave Ste B
Brooklyn, NY 11207-7905
Phone
(347) 689-8880
Fax
(347) 689-8860
NPI assigned
Apr 13, 2011
Last updated
Mar 7, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 7, 2025

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

Authorized official

Name
Ilya Kleyn, M.DNPI 1851327092
Title
M.D.
Phone
(347) 689-8880

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
Geriatric Medicine (Internal Medicine) PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207RG0300X 215006 NY Primary

Addresses

Primary practice location

699 Stanley Ave Ste B
Brooklyn, NY 11207-7905

Mailing address

699 Stanley Ave
Brooklyn, NY 11207-7905
Phone (347) 689-8880

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20120208000357 NY Part B Supplier - Clinic/Group Practice 2961669643 Receives reassigned benefits from 17 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
33D2042119Nyc Medical Doctor PC699 Stanley Avenue, Brooklyn, NY 11207Certificate of waiverJun 5, 2028

National Provider Directory

National Provider Directory

Locations

699 Stanley Ave
Ste B
Brooklyn, NY 11207
Phone (347) 689-8880

Practitioners & affiliated clinicians

Practitioners 18

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 18

NPI Registry JSON

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

{
    "created_epoch": "1302652800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1741305600000",
    "number": "1831489798",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "699 STANLEY AVE",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112077905",
            "telephone_number": "347-689-8880",
            "fax_number": "347-689-8860"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "699 STANLEY AVE STE B",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112077905",
            "telephone_number": "347-689-8880",
            "fax_number": "347-689-8860"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NYC MEDICAL DOCTOR P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-04-13",
        "last_updated": "2025-03-07",
        "certification_date": "2025-03-07",
        "status": "A",
        "authorized_official_last_name": "KLEYN",
        "authorized_official_first_name": "ILYA",
        "authorized_official_title_or_position": "M.D.",
        "authorized_official_telephone_number": "347-689-8880",
        "authorized_official_credential": "M.D"
    },
    "taxonomies": [
        {
            "code": "207RG0300X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine, Geriatric Medicine",
            "state": "NY",
            "license": "215006",
            "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 Mar 7, 2025; 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.