Brooklyn Queens Nursing Home, Inc

Primary specialty

Skilled Nursing FacilityTaxonomy code 314000000X

License

7001382N Issued in NY

Legal business name

BROOKLYN QUEENS NURSING HOME, INC

Practice address

2749 Linden Blvd
Brooklyn, NY 11208-5110

Phone

(718) 277-5100

Fax

(718) 647-2597

NPI assigned

Oct 20, 2005

Organization subpart

No

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

Authorized official

Name

Mr. Marty Dicker

Title

Administrator

Phone

(718) 277-5100

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in NY

Enrollment records 1

Skilled nursing facility certification: CCN 335637001

Legal name

BROOKLYN QUEENS NURSING HOME INC

Organization structure

CorporationProprietary

Incorporated

Jul 9, 1998 in NY

Enrollment address

2749 Linden Blvd
Brooklyn, NY 11208-5110

Nursing home name

BROOKLYN-QUEENS NURSING HOME

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

All disclosed owners & managing parties 12

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

Owners & managing parties with NPI records 1

Owners and managing parties disclosed on this facility’s Medicare enrollment that are themselves Medicare-enrolled.

• Peyman Younesi, M.D.

  • Internal Medicine Physician
  • Staten Island, NY
  • NPI 1891942645

  Adp of the SNF, Operational/Managerial Control

  CMS ownership

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Peyman Younesi, M.D.

  • Internal Medicine Physician
  • Staten Island, NY
  • NPI 1891942645
  NPD (past)

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

{
    "created_epoch": "1129766400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1478044800000",
    "number": "1871582825",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2749 LINDEN BLVD",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112085110",
            "telephone_number": "718-277-5100",
            "fax_number": "718-647-2597"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2749 LINDEN BLVD",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112085110",
            "telephone_number": "718-277-5100",
            "fax_number": "718-647-2597"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BROOKLYN QUEENS NURSING HOME, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-10-20",
        "last_updated": "2016-11-02",
        "status": "A",
        "authorized_official_last_name": "DICKER",
        "authorized_official_first_name": "MARTY",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "718-277-5100",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "NY",
            "license": "7001382N",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Skilled Nursing Facility in Brooklyn, NY
• Providers in Brooklyn, NY by specialty
• Skilled Nursing Facility in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 2, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; facility enrollments, owners and changes of ownership; Provider of Services certification data.
• 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.