NPIMap

Organization Active NPI

Fulton Medical Plaza, P.C.

  • Primary Care Clinic/Center
  • Brooklyn, NY
National Provider Identifier
1982899944
Registry record updated Sep 19, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Primary Care Clinic/CenterTaxonomy code 261QP2300X
Legal business name
FULTON MEDICAL PLAZA, P.C.
Practice address
1545 Atlantic Ave
Suite 108
Brooklyn, NY 11213-1122
Phone
(718) 622-2525
Fax
(718) 622-7177
NPI assigned
Sep 12, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 19, 2014

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

Authorized official

Name
Dr. Benjamin Barrah, M.DNPI 1194873273
Title
President
Phone
(718) 622-2525

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
Primary Care Clinic/Center 261QP2300X Primary

Addresses

Primary practice location

1545 Atlantic Ave
Suite 108
Brooklyn, NY 11213-1122

Mailing address

1545 Atlantic Ave
Suite 108
Brooklyn, NY 11213-1122
Phone (718) 622-2525

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20041119000800 NY Part B Supplier - Clinic/Group Practice 1254396187 Receives reassigned benefits from 1 practitioner
Practice locations: Brooklyn, NY

National Provider Directory

National Provider Directory

Locations

1209 Fulton St
Brooklyn, NY 11216
Phone (718) 622-0771

Practitioners & affiliated clinicians

Practitioners 6

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": "1189555200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1411084800000",
    "number": "1982899944",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1545 ATLANTIC AVE",
            "address_2": "SUITE 108",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112131122",
            "telephone_number": "718-622-2525",
            "fax_number": "718-622-7177"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1545 ATLANTIC AVE",
            "address_2": "SUITE 108",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112131122",
            "telephone_number": "718-622-2525",
            "fax_number": "718-622-7177"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FULTON MEDICAL PLAZA, P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-09-12",
        "last_updated": "2014-09-19",
        "status": "A",
        "authorized_official_last_name": "BARRAH",
        "authorized_official_first_name": "BENJAMIN",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "718-622-2525",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D"
    },
    "taxonomies": [
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "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 Sep 19, 2014; 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.