Organization Active NPI

Sam Katzurin MD PC

  • Ophthalmology Physician
  • Brooklyn, NY
National Provider Identifier
1831499375
Registry record updated Feb 16, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ophthalmology PhysicianTaxonomy code 207W00000X
License
131528 Issued in NY
Legal business name
SAM KATZURIN MD PC
Practice address
161 Atlantic Ave
Ste. 203
Brooklyn, NY 11201-6720
Phone
(718) 852-5232
Fax
(718) 596-9085
NPI assigned
Nov 1, 2010
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 16, 2011

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

Authorized official

Name
Dr. Sam Katzurin, M.D.NPI 1306967211
Title
President
Phone
(516) 482-2034

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
Ophthalmology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207W00000X 131528 NY Primary

Addresses

Primary practice location

161 Atlantic Ave
Ste. 203
Brooklyn, NY 11201-6720

Mailing address

11 Stony Run Rd
Great Neck, NY 11023-1923
Phone (516) 482-2034

Other identifiers 1

IdentifierTypeStateIssuer
00374552MedicaidNY

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20110310000525 NY Part B Supplier - Clinic/Group Practice 4183806268 Receives reassigned benefits from 1 practitioner
Practice locations: Brooklyn, NY

National Provider Directory

National Provider Directory

Locations

2237 Linden Blvd
Brooklyn, NY 11207
Phone (718) 604-8370

161 Atlantic Ave
Ste 203
Brooklyn, NY 11201
Phone (718) 596-1389

520 Prospect Pl
Brooklyn, NY 11238
Phone (718) 616-1000

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": "1288569600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1297814400000",
    "number": "1831499375",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11 STONY RUN RD",
            "city": "GREAT NECK",
            "state": "NY",
            "postal_code": "110231923",
            "telephone_number": "516-482-2034",
            "fax_number": "516-829-2539"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "161 ATLANTIC AVE",
            "address_2": "STE. 203",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112016720",
            "telephone_number": "718-852-5232",
            "fax_number": "718-596-9085"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SAM KATZURIN MD PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-11-01",
        "last_updated": "2011-02-16",
        "status": "A",
        "authorized_official_last_name": "KATZURIN",
        "authorized_official_first_name": "SAM",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "516-482-2034",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Ophthalmology",
            "state": "NY",
            "license": "131528",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00374552",
            "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 16, 2011; 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.