NPIMap

Organization Active NPI

L'Refuah Medical & Rehabilitation Center, Inc.

  • Community Health Worker
  • Brooklyn, NY
National Provider Identifier
1861859878
Registry record updated Sep 7, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community Health WorkerTaxonomy code 172V00000X
Legal business name
L'REFUAH MEDICAL & REHABILITATION CENTER, INC.
Practice address
1260-78 60TH St
Brooklyn, NY 11219-4929
Phone
(718) 686-7600
NPI assigned
Jan 21, 2016
Last updated
Sep 7, 2016By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 7, 2016

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

Authorized official

Name
Mrs. Miryam Nakash
Title
Credentialing Secretary
Phone
(347) 820-1872

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community Health Worker 172V00000X Primary

Addresses

Primary practice location

1260-78 60TH St
Brooklyn, NY 11219-4929

Mailing address

1312 38TH St
Brooklyn, NY 11218-3612

Other identifiers 3

IdentifierTypeStateIssuer
331052OtherNYMEDICARE A
02157835MedicaidNY
W86661OtherNYMEDICARE B

Other names 1

  • Ezra Medical Women's Health Center Other name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20040512001035 NY Part B Supplier - Clinic/Group Practice 8628068731 Receives reassigned benefits from 23 practitioners
1 other NPI on this enrollment
Practice locations: Brooklyn, NY
O20170110000433 NY Part A Provider - Federally Qualified Health Center (FQHC) 8628068731 Practice locations: Brooklyn, NY

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1861859878. Details of each certification follow.

Federally qualified health center certification: CCN 571065

Legal name
L'REFUAH MEDICAL & REHABILITATION CENTER, INC.
Doing business as
EZRA MEDICAL WOMENS AND FAMILY CENTER
Certification status
Active
Provider type (POS)
Federally qualified health center
Participating since
Apr 1, 2017
Last certification
Apr 1, 2017
Ownership / control type
For profit – corporation
Organization structure
CorporationNon-profit
Incorporated
Sep 18, 2000 in NY
Enrollment address
1260 60TH St
# 78
Brooklyn, NY 11219-4976

Other NPIs with the same Medicare PAC ID 3

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

Other NPIs on the same Medicare enrollment 1

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

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
33D2324775Ezra Medical Women's and Family Health Center1260-78 60TH St, Brooklyn, NY 11219Certificate of waiverMar 26, 2027

National Provider Directory

National Provider Directory

Ownership & related parties

All disclosed owners & managing parties 11

As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.

NameRoleSinceShare
Gittel Klein Individual Corporate DirectorBoard Member Vice Chair Jun 30, 2003
Avrom Porges Individual Corporate DirectorBoard Member Apr 29, 2009
David Chimmel Individual Corporate DirectorBoard Member Jun 30, 2003
Allen Lichtenstein Individual Corporate OfficerCoo Mar 2, 2011
Yitty Grunwald Individual Corporate DirectorBoard Member Jun 30, 2003
Joshua Silberberg Individual Corporate DirectorBoard Member Treasurer Jan 7, 2002
Basya Ungar Individual Corporate OfficerCeo Oct 28, 2002
W-2 Managing EmployeeCeo Oct 28, 2002
Herman Silberstein Individual Corporate DirectorBoard Member Chairman Jun 30, 2003
Ischa Hecht Individual Corporate OfficerCeo Mar 4, 2002
W-2 Managing EmployeeCeo Mar 4, 2002
Berl Graus Individual Corporate DirectorBoard Member Secretary Jun 30, 2003
Beila Grossman Individual Corporate DirectorBoard Member Nov 24, 2010

All facility ownership & control disclosures 1

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Ezra Medical CenterBrooklyn, NY, CCN 571914 Federally qualified health center Other Jan 1, 2000

Owned or controlled facilities with NPI records 1

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

Practitioners & affiliated clinicians

Practitioners 23

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 23

NPI Registry JSON

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

{
    "created_epoch": "1453334400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1473206400000",
    "number": "1861859878",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1312 38TH ST",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112183612"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1260-78 60TH ST",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112194929",
            "telephone_number": "718-686-7600"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "L'REFUAH MEDICAL & REHABILITATION CENTER, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-01-21",
        "last_updated": "2016-09-07",
        "status": "A",
        "authorized_official_last_name": "NAKASH",
        "authorized_official_first_name": "MIRYAM",
        "authorized_official_title_or_position": "CREDENTIALING SECRETARY",
        "authorized_official_telephone_number": "347-820-1872",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "172V00000X",
            "taxonomy_group": "",
            "desc": "Community Health Worker",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE A",
            "identifier": "331052",
            "state": "NY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02157835",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE B",
            "identifier": "W86661",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Ezra Medical Women's Health Center",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Brooklyn, NY

Sources for this page

Verify at the official NPI Registry.