Organization Active NPI

TBHC Pediatric Services PC

  • Pediatrics Physician
  • Brooklyn, NY
National Provider Identifier
1861628091
Registry record updated Apr 10, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
Legal business name
TBHC PEDIATRIC SERVICES PC
Practice address
240 Willoughby St
Brooklyn, NY 11201-5465
Phone
(718) 250-6607
Fax
(718) 250-6850
NPI assigned
Jun 2, 2009
Last updated
Apr 10, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 10, 2025

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

Authorized official

Name
Kenneth Bromberg, MD
Title
Shareholder
Phone
(718) 250-6607

Specialties & licenses 15

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X
Clinical Genetics (M.D.) Physician 207SG0201X
Pediatrics Physician 208000000X Primary
Pediatric Adolescent Medicine Physician 2080A0000X
Neonatal-Perinatal Medicine Physician 2080N0001X
Pediatric Cardiology Physician 2080P0202X
Pediatric Critical Care Medicine Physician 2080P0203X
Pediatric Emergency Medicine (Pediatrics) Physician 2080P0204X
Pediatric Endocrinology Physician 2080P0205X
Pediatric Gastroenterology Physician 2080P0206X
Pediatric Hematology & Oncology Physician 2080P0207X
Pediatric Infectious Diseases Physician 2080P0208X
Pediatric Nephrology Physician 2080P0210X
Neurology with Special Qualifications in Child Neurology Physician 2084N0402X
Hospitalist Physician 208M00000X

Addresses

Primary practice location

240 Willoughby St
Brooklyn, NY 11201-5465

Mailing address

PO Box 13643
Philadelphia, PA 19101-3643
Phone (315) 446-3904

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20091007000483 NY Part B Supplier - Clinic/Group Practice 8325184401 Receives reassigned benefits from 26 practitioners
Practice locations: Brooklyn, NY

National Provider Directory

National Provider Directory

Locations

121 DeKalb Ave
Fl 10
Brooklyn, NY 11201

121 DeKalb Ave
Ste Er
Brooklyn, NY 11201

121 DeKalb Ave
Ste Inpt
Brooklyn, NY 11201

2222 Church Ave
Brooklyn, NY 11226
Phone (718) 250-8205

771 61st St
Brooklyn, NY 11220
Phone (718) 851-2323

Practitioners & affiliated clinicians

Practitioners 57

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 57

NPI Registry JSON

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

{
    "created_epoch": "1243900800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1744243200000",
    "number": "1861628091",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 13643",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191013643",
            "telephone_number": "315-446-3904",
            "fax_number": "315-362-5179"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "240 WILLOUGHBY ST",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112015465",
            "telephone_number": "718-250-6607",
            "fax_number": "718-250-6850"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TBHC PEDIATRIC SERVICES PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-06-02",
        "last_updated": "2025-04-10",
        "certification_date": "2025-04-10",
        "status": "A",
        "authorized_official_last_name": "BROMBERG",
        "authorized_official_first_name": "KENNETH",
        "authorized_official_title_or_position": "SHAREHOLDER",
        "authorized_official_telephone_number": "718-250-6607",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207SG0201X",
            "taxonomy_group": "",
            "desc": "Medical Genetics, Clinical Genetics (M.D.)",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "2080A0000X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Adolescent Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2080N0001X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Neonatal-Perinatal Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2080P0202X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Cardiology",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2080P0203X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Critical Care Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2080P0204X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Emergency Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2080P0205X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Endocrinology",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2080P0206X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Gastroenterology",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2080P0207X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Hematology-Oncology",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2080P0208X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Infectious Diseases",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2080P0210X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Nephrology",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2084N0402X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology with Special Qualifications in Child Neurology",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "208M00000X",
            "taxonomy_group": "",
            "desc": "Hospitalist",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "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 Apr 10, 2025; 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.