Organization Active NPI

Five Star Pharmacy Inc

  • Pharmacy
  • Brooklyn, NY
National Provider Identifier
1902940307
Registry record updated Dec 17, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacyTaxonomy code 333600000X
Legal business name
FIVE STAR PHARMACY INC
Practice address
4125 18TH Ave
Brooklyn, NY 11218-5709
Phone
(718) 686-8900
NPI assigned
Feb 18, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 17, 2007

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

Authorized official

Name
Sofiya GutmanNPI 1336465541
Title
Owner
Phone
(718) 686-8900

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacy 333600000X Primary

Addresses

Primary practice location

4125 18TH Ave
Brooklyn, NY 11218-5709

Mailing address

4125 18TH Ave
Brooklyn, NY 11218-5709
Phone (718) 686-8900

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20100930070362 NY DME Supplier - Pharmacy 9032313762 Practice locations: Brooklyn, NY

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.

Medicare medical equipment & supply locations

SupplierSuppliesMedicare assignment
Five Star Pharmacy4125 18TH Ave, Brooklyn, NY 11218-5709(718) 686-8900 Blood Glucose Monitors/Supplies (Non-Mail Order)|Blood Glucose Monitors/Supplies (Mail Order)|Canes and/or Crutches|Walkers|Enteral Nutrients|Surgical Dressings|Lymphedema Compression Treatment Items Does not accept assignmentParticipating since Jun 15, 2007

National Provider Directory

National Provider Directory

Locations

4125 18th Ave
Brooklyn, NY 11218
Phone (718) 686-8900

Practitioners & affiliated clinicians

Practitioners 1

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

NPI Registry JSON

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

{
    "created_epoch": "1171756800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1197849600000",
    "number": "1902940307",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4125 18TH AVE",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112185709",
            "telephone_number": "718-686-8900",
            "fax_number": "718-686-8910"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4125 18TH AVE",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112185709",
            "telephone_number": "718-686-8900"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FIVE STAR PHARMACY INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-18",
        "last_updated": "2007-12-17",
        "status": "A",
        "authorized_official_last_name": "GUTMAN",
        "authorized_official_first_name": "SOFIYA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "718-686-8900"
    },
    "taxonomies": [
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "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 Dec 17, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • 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.