NPIMap

Organization Active NPI

A Merryland Operating LLC

  • Adolescent Medicine (Family Medicine) Physician
  • Brooklyn, NY
National Provider Identifier
1972848307
Registry record updated Jun 22, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adolescent Medicine (Family Medicine) PhysicianTaxonomy code 207QA0000X
License
097912 Issued in NY
Legal business name
A MERRYLAND OPERATING LLC
Practice address
2873 W 17TH St FL 2
Brooklyn, NY 11224-2611
Phone
(718) 265-0900
Fax
(718) 360-2279
NPI assigned
Dec 12, 2012
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 22, 2021

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

Authorized official

Name
Mrs. Lidiya Leshchinskiy
Title
Owner
Phone
(718) 265-0900

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Adolescent Medicine (Family Medicine) PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207QA0000X 097912 NY Primary

Addresses

Primary practice location

2873 W 17TH St FL 2
Brooklyn, NY 11224-2611

Mailing address

2873 W 17TH St FL 2
Brooklyn, NY 11224-2611
Phone (718) 265-0900

Other practice location 1

1704-06 Mermaid Ave
Brooklyn, NY 11224-2622
Phone (718) 265-0900

Other identifiers 1

IdentifierTypeStateIssuer
7001134ROtherNYOPERATING CERTIFICATE

Other names 1

  • A MERRYLAND HEALTH CENTER Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY, TX2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20131017001230 NY Part B Supplier - Clinic/Group Practice 5890929210 Receives reassigned benefits from 20 practitioners
Practice locations: Brooklyn, NY
O20230612002941 TX Part B Supplier - Clinic/Group Practice 5890929210 Receives reassigned benefits from 1 practitioner
Practice locations: McKinney, TX

National Provider Directory

National Provider Directory

Locations

1704 Mermaid Ave
#6
Brooklyn, NY 11224
Phone (718) 265-0900

2873 W 17th St
Fl 2
Brooklyn, NY 11224
Phone (718) 265-0900

Practitioners & affiliated clinicians

Practitioners 63

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

View all 63

NPI Registry JSON

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

{
    "created_epoch": "1355270400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1624320000000",
    "number": "1972848307",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2873 W 17TH ST FL 2",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112242611",
            "telephone_number": "718-265-0900",
            "fax_number": "718-360-2279"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2873 W 17TH ST FL 2",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112242611",
            "telephone_number": "718-265-0900",
            "fax_number": "718-360-2279"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1704-06 MERMAID AVE",
            "address_purpose": "LOCATION",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112242622",
            "country_code": "US",
            "telephone_number": "718-265-0900",
            "fax_number": "718-360-2279",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "A MERRYLAND OPERATING LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-12-12",
        "last_updated": "2021-06-22",
        "certification_date": "2021-06-21",
        "status": "A",
        "authorized_official_last_name": "LESHCHINSKIY",
        "authorized_official_first_name": "LIDIYA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "718-265-0900",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "207QA0000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine, Adolescent Medicine",
            "state": "NY",
            "license": "097912",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OPERATING CERTIFICATE",
            "identifier": "7001134R",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "A MERRYLAND HEALTH CENTER",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "A MERRYLAND HEALTH CENTER",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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 Jun 22, 2021; 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.