NPIMap

Organization Active NPI

Brooklyn Medical Associates, PC

  • Family Medicine Physician
  • Fort Wayne, IN
National Provider Identifier
1851512198
Registry record updated Nov 6, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
50000594A Issued in IN
Legal business name
BROOKLYN MEDICAL ASSOCIATES, PC
Practice address
5717 S Anthony Blvd
Suite 100
Fort Wayne, IN 46806-3386
Phone
(260) 747-6171
Fax
(260) 478-5125
NPI assigned
May 2, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 6, 2007

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

Authorized official

Name
Bill Ehinger
Title
Ceo
Phone
(260) 478-5226

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207Q00000X 50000594A IN Primary

Addresses

Primary practice location

5717 S Anthony Blvd
Suite 100
Fort Wayne, IN 46806-3386

Mailing address

3534 Brooklyn Ave
Fort Wayne, IN 46809-1361
Phone (260) 747-6171

National Provider Directory

National Provider Directory

Member of 1

Organizations this organization is a member of, according to the National Provider Directory.

Locations

7980 W Jefferson Blvd
Fort Wayne, IN 46804
Phone (260) 459-1587

5717 S Anthony Blvd
Ste 100
Fort Wayne, IN 46806
Phone (260) 469-2984

Practitioners & affiliated clinicians

Practitioners 7

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": "1178064000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1194307200000",
    "number": "1851512198",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3534 BROOKLYN AVE",
            "city": "FORT WAYNE",
            "state": "IN",
            "postal_code": "468091361",
            "telephone_number": "260-747-6171",
            "fax_number": "260-478-5125"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5717 S ANTHONY BLVD",
            "address_2": "SUITE 100",
            "city": "FORT WAYNE",
            "state": "IN",
            "postal_code": "468063386",
            "telephone_number": "260-747-6171",
            "fax_number": "260-478-5125"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BROOKLYN MEDICAL ASSOCIATES, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-02",
        "last_updated": "2007-11-06",
        "status": "A",
        "authorized_official_last_name": "EHINGER",
        "authorized_official_first_name": "BILL",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "260-478-5226"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": "IN",
            "license": "50000594A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Wayne, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 6, 2007; 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.