Individual provider Active NPI

Imad J. Bakoss, M.D.

  • Pulmonary Disease Physician
  • Brooklyn, NY
National Provider Identifier
1881652055
Registry record updated Apr 23, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pulmonary Disease PhysicianTaxonomy code 207RP1001X
License
129319 Issued in NY
Practice address
2165 71St St
Brooklyn, NY 11204-5526
Phone
(718) 621-7100
Fax
(718) 621-7103
NPI assigned
May 3, 2006
Last updated
Apr 23, 2008By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 23, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pulmonary Disease Physician 207RP1001X 129319 NY Primary

Addresses

Primary practice location

2165 71St St
Brooklyn, NY 11204-5526

Mailing address

2165 71St St
Brooklyn, NY 11204-5526
Phone (718) 621-7100

Other identifiers 1

IdentifierTypeStateIssuer
00271187MedicaidNY

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
129319NYMDPulmonary Disease Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Mermaid Operating Co, LLC PastSince Nov 4, 2005 Accepting new patients
Imad John Bakoss Pulmonary Disease PastSince Jan 1, 1990 Accepting new patients
LMC Physician Services, PC Pulmonary Disease Past Accepting new patients
Lung and Sleep Medicine P.C. Pulmonary Disease PastSince Apr 1, 2007 Accepting new patients

Organizations & group practices 5

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1146614400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1208908800000",
    "number": "1881652055",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2165 71ST ST",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112045526",
            "telephone_number": "718-621-7100",
            "fax_number": "718-621-7103"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2165 71ST ST",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112045526",
            "telephone_number": "718-621-7100",
            "fax_number": "718-621-7103"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BAKOSS",
        "first_name": "IMAD",
        "middle_name": "J.",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-05-03",
        "last_updated": "2008-04-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RP1001X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Pulmonary Disease",
            "state": "NY",
            "license": "129319",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00271187",
            "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 Apr 23, 2008; 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.