Individual provider Active NPI

Jeffrey Thomas Rallo, M.D.

  • Pediatric Emergency Medicine (Pediatrics) Physician
  • Brooklyn, NY
National Provider Identifier
1881821932
Registry record updated Oct 23, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Emergency Medicine (Pediatrics) PhysicianTaxonomy code 2080P0204X
License
278694 Issued in NY
Practice address
451 Clarkson Ave
Emergency Dept
Brooklyn, NY 11203-2054
Phone
(718) 245-3131
NPI assigned
Jun 16, 2009
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 23, 2015

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Pediatric Emergency Medicine (Pediatrics) Physician 2080P0204X 278694 NY Primary

Addresses

Primary practice location

451 Clarkson Ave
Emergency Dept
Brooklyn, NY 11203-2054

Mailing address

7912 3Rd Ave
Apt 2
Brooklyn, NY 11209-3602
Phone (860) 214-3812

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20160516001666 NY Practitioner - Pediatric Medicine 0143450650 Reassigns benefits to 2 organizations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
The Brookdale Hospital Medical Center CurrentSince Feb 27, 2016 Accepting new patients
Brookdale Hospital Medical Center CurrentSince Feb 27, 2016 Accepting new patients
Downtown Bronx Medical Associates PC CurrentSince Mar 1, 2020 Accepting new patients

Locations

234 Eugenio Maria de Hosto Blvd
Bronx, NY 10451
Phone (718) 579-5874

1235 Linden Blvd
Fl 2
Brooklyn, NY 11212
Phone (718) 240-7143

1 Brookdale Plz
Brooklyn, NY 11212
Phone (718) 240-5212

Networks

  • Healthfirst Medicare Network H3359
  • Healthfirst Medicare Network H1722
  • Healthfirst Medicare Network H5989
  • Healthfirst Medicare Network H9678

Interoperability endpoints

  • Direct secure messaging: jrallo1055545@nychhc.direct-ci.com

Organizations & group practices 3

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

NPI Registry JSON

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

{
    "created_epoch": "1245110400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1445558400000",
    "number": "1881821932",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7912 3RD AVE",
            "address_2": "APT 2",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112093602",
            "telephone_number": "860-214-3812"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "451 CLARKSON AVE",
            "address_2": "EMERGENCY DEPT",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112032054",
            "telephone_number": "718-245-3131"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RALLO",
        "first_name": "JEFFREY",
        "middle_name": "THOMAS",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2009-06-16",
        "last_updated": "2015-10-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2080P0204X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Emergency Medicine",
            "state": "NY",
            "license": "278694",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brooklyn, NY

Sources for this page

Verify at the official NPI Registry.