Organization Active NPI

Roman Brushtein Medical PLLC

  • Internal Medicine Physician
  • Lynbrook, NY
National Provider Identifier
1952435182
Registry record updated Feb 11, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
Legal business name
ROMAN BRUSHTEIN MEDICAL PLLC
Practice address
303 Merrick Rd
Suite 511
Lynbrook, NY 11563-2501
Phone
(516) 596-3611
Fax
(516) 596-3612
NPI assigned
Mar 16, 2007
Last updated
Feb 11, 2009By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 11, 2009

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

Authorized official

Name
Dr. Roman Brushtein, MDNPI 1194786772
Title
Owner
Phone
(516) 596-3611

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
Internal Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207R00000X NY Primary

Addresses

Primary practice location

303 Merrick Rd
Suite 511
Lynbrook, NY 11563-2501

Mailing address

303 Merrick Rd
Suite 511
Lynbrook, NY 11563-2501
Phone (516) 596-3611

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20060503000071 NY Part B Supplier - Clinic/Group Practice 5193735389 Receives reassigned benefits from 1 practitioner
Practice locations: Lynbrook, NY

National Provider Directory

National Provider Directory

Locations

865 Merrick Rd
Ste 300
Baldwin, NY 11510
Phone (516) 378-0880

303 Merrick Rd
Ste 511
Lynbrook, NY 11563
Phone (516) 315-3885

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1174003200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1234310400000",
    "number": "1952435182",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "303 MERRICK RD",
            "address_2": "SUITE 511",
            "city": "LYNBROOK",
            "state": "NY",
            "postal_code": "115632501",
            "telephone_number": "516-596-3611",
            "fax_number": "516-596-3612"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "303 MERRICK RD",
            "address_2": "SUITE 511",
            "city": "LYNBROOK",
            "state": "NY",
            "postal_code": "115632501",
            "telephone_number": "516-596-3611",
            "fax_number": "516-596-3612"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ROMAN BRUSHTEIN MEDICAL PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-16",
        "last_updated": "2009-02-11",
        "status": "A",
        "authorized_official_last_name": "BRUSHTEIN",
        "authorized_official_first_name": "ROMAN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "516-596-3611",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine",
            "state": "NY",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lynbrook, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 11, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.