Individual provider Active NPI

Eliezer L. Offenbacher, M.D.

  • Diagnostic Radiology Physician
  • Brooklyn, NY
National Provider Identifier
1891746517
Registry record updated Jan 15, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
License
147975-1 Issued in NY
Practice address
2270 Kimball St
Suite 102
Brooklyn, NY 11234-5139
Phone
(718) 253-6616
Fax
(718) 407-1140
NPI assigned
May 15, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 15, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Radiology Physician 2085R0202X 147975-1 NY Primary

Addresses

Primary practice location

2270 Kimball St
Suite 102
Brooklyn, NY 11234-5139

Mailing address

2270 Kimball St
Suite 102
Brooklyn, NY 11234-5139
Phone (718) 253-6616

Other identifiers 1

IdentifierTypeStateIssuer
00897383MedicaidNY

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
I20051118000589 NY Practitioner - Diagnostic Radiology 3375562366 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Diagnostic Radiology
Education
State University of Ny Upstate Medical University, 1980
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

3852 Nostrand Ave
Brooklyn, NY 11235-2013
Phone (718) 743-2300

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
147975-1NYMDDiagnostic Radiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
South Brooklyn Radiology PLLC Diagnostic Radiology CurrentSince Aug 31, 2012 Accepting new patients
Integrated Diagnostic Imaging & Cardiology of Staten Island P.C. Diagnostic Radiology CurrentSince Oct 1, 2007 Accepting new patients
MRI Associates of Queens, PC CurrentSince Apr 4, 1996 Accepting new patients
Simon Lipetz MD. P.C CurrentSince Jan 1, 2010 Accepting new patients
Radiology Associates of Brooklyn, LLP PastSince Jul 6, 2001 Accepting new patients
Stony Brook Radiologic Services PC Diagnostic Radiology Past Accepting new patients

Locations

3852 Nostrand Ave
Brooklyn, NY 11235
Phone (718) 723-4300

10460 Queens Blvd
Ste Ch
Forest Hills, NY 11375
Phone (212) 663-3600

9237 Metropolitan Ave
Forest Hills, NY 11375
Phone (718) 544-7994

1776 Richmond Rd
Staten Island, NY 10306
Phone (718) 370-8900

2052 Richmond Rd
Ste B
Staten Island, NY 10306
Phone (201) 888-7877

Organizations & group practices 6

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": "1147651200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1200355200000",
    "number": "1891746517",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2270 KIMBALL ST",
            "address_2": "SUITE 102",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112345139",
            "telephone_number": "718-253-6616",
            "fax_number": "718-407-1140"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2270 KIMBALL ST",
            "address_2": "SUITE 102",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112345139",
            "telephone_number": "718-253-6616",
            "fax_number": "718-407-1140"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OFFENBACHER",
        "first_name": "ELIEZER",
        "middle_name": "L.",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-15",
        "last_updated": "2008-01-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "NY",
            "license": "147975-1",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00897383",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Brooklyn, NY

Sources for this page

Verify at the official NPI Registry.