Organization Active NPI

Atlantic Medical PC

  • Legal Medicine
  • Brooklyn, NY
National Provider Identifier
1942421979
Registry record updated Dec 21, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Legal MedicineTaxonomy code 173000000X
License
197845 Issued in NY
Legal business name
ATLANTIC MEDICAL PC
Practice address
745 Ocean Pkwy
Brooklyn, NY 11230-1113
Phone
(718) 677-9700
Fax
(718) 859-5969
NPI assigned
May 1, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 21, 2011

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

Authorized official

Name
Dr. Miron FayngershNPI 1902918279
Title
President
Phone
(718) 677-9700

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
Legal MedicineGroup: 193200000X MULTI-SPECIALTY GROUP 173000000X 197845 NY Primary

Addresses

Primary practice location

745 Ocean Pkwy
Brooklyn, NY 11230-1113

Mailing address

745 Ocean Pkwy
Brooklyn, NY 11230-1113
Phone (718) 677-9700

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040322001105 NY Part B Supplier - Clinic/Group Practice 1052202918 Receives reassigned benefits from 6 practitioners
Practice locations: Brooklyn, NY; Staten Island, 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.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
33D1103615Atlantic Medical PC745 Ocean Pkwy, Brooklyn, NY 11230Certificate of waiverAug 12, 2027

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 7

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": "1177977600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1324425600000",
    "number": "1942421979",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "745 OCEAN PKWY",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112301113",
            "telephone_number": "718-677-9700",
            "fax_number": "718-859-5969"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "745 OCEAN PKWY",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112301113",
            "telephone_number": "718-677-9700",
            "fax_number": "718-859-5969"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ATLANTIC MEDICAL PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-01",
        "last_updated": "2011-12-21",
        "status": "A",
        "authorized_official_last_name": "FAYNGERSH",
        "authorized_official_first_name": "MIRON",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "718-677-9700",
        "authorized_official_name_prefix": "Dr."
    },
    "taxonomies": [
        {
            "code": "173000000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Legal Medicine",
            "state": "NY",
            "license": "197845",
            "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 21, 2011; 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.