KINGSBORO PC (NPI# 1992997746) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1992997746 |
| Entity Type | Organization |
| Organization Name | KINGSBORO PC |
| Practice Address |
681 Clarkson Ave Brooklyn NY 11203-2125 |
| Mailing Address |
44 Holland Ave Albany NY 12229-0001 |
| Practice Telephone | 7182217700 |
| Enumeration Date | 2007-08-15 |
| Last Update Date | 2015-03-16 |
| Authorized Official Name | ROBERT PUCCIO (DIRECTOR, FINANCE) |
| Authorized Official Telephone | 5184730795 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 302R00000X | Health Maintenance Organization | Managed Care Organizations |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| NY | 02890893 | 05 |
| Street Address |
681 CLARKSON AVE |
| City | BROOKLYN |
| State | NY |
| Zip Code | 11203-2125 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1457431546 | Dhananjay A Bhagogi | Internal Medicine | 681 Clarkson Ave, Building 2, Brooklyn, NY 11203-2125 | 2006-10-16 |
| 1588295034 | Victoria Tayese | Registered Nurse | 681 Clarkson Ave, Brooklyn, NY 11203-2125 | 2020-02-03 |
| 1548806979 | William Brown | Student in an Organized Health Care Education/Training Program | 681 Clarkson Ave, Brooklyn, NY 11203-2125 | 2019-11-20 |
| 1295378461 | Racheal Olufunke Ajiboye | Registered Nurse | 681 Clarkson Ave, Brooklyn, NY 11203-2125 | 2019-10-21 |
| 1194367854 | Rose Boutin | Registered Nurse | 681 Clarkson Ave, Brooklyn, NY 11203-2125 | 2019-10-15 |
| 1508407875 | Nathaniel Ajibade | Registered Nurse | 681 Clarkson Ave, Brooklyn, NY 11203-2199 | 2019-10-08 |
| 1316588684 | Modupe Kolawole | Registered Nurse | 681 Clarkson Ave, Brooklyn, NY 11203-2199 | 2019-10-08 |
| 1861033359 | Irshad Amirali Sumar | Psychiatry & Neurology | 681 Clarkson Ave, Brooklyn, NY 11203-2199 | 2019-10-05 |
| 1710528799 | Corazon Tapere Ty | Registered Nurse | 681 Clarkson Ave, Brooklyn, NY 11203-2125 | 2019-10-01 |
| 1043851215 | Raisa Suelyn Harrington | Registered Nurse | 681 Clarkson Ave, Brooklyn, NY 11203-2125 | 2019-09-30 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1023615747 | Winnie Ming Wong | Dance Therapist | 451 Clarkson Ave R Building, Idd/mh Unit, R5west, Brooklyn, NY 11203 | 2020-10-06 |
| 1174134803 | Jermiah Jonoah Jones | Social Worker | 307 E 54th St, 3, Brooklyn, NY 11203 | 2020-08-14 |
| 1780201566 | Jesvin Jeyapaulraj | Student in an Organized Health Care Education/Training Program | 450 Clarkson Avenue, Suny Downstate, General Surgery Department, Brooklyn, NY 11203 | 2020-06-29 |
| 1881219731 | Natasha Thomas | Specialist | 140 East 52nd St Brooklyn, Apt 1r, Brooklyn, NY 11203 | 2020-06-16 |
| 1679197396 | Syed Hamza Bin Waqar | Student in an Organized Health Care Education/Training Program | 450 Clarkson Avenue, Msc 50, Suny Downstate, Brooklyn, NY 11203 | 2020-05-29 |
| 1013536846 | Isaak Rubinov | Student in an Organized Health Care Education/Training Program | 91 E 39th St, Brooklyn, NY 11203 | 2020-04-12 |
| 1932733615 | Shade Celestine | Specialist | 293 East53rd Street, Brooklyn, NY 11203 | 2020-03-03 |
| 1023656147 | Shenez Brutus | Nurse Practitioner | Suny Downstate College of Nursing, 450 Clarkson Avenue, Brooklyn, NY 11203 | 2019-12-19 |
| 1215586425 | Terry-ann Lee | Registered Nurse | 440 East 45th Street, Kings, NY 11203 | 2019-09-10 |
| 1568023828 | Mmeyeneabasi David Omede | Student in an Organized Health Care Education/Training Program | 450 Clarkson Avenue, Suny Downstate Medical Center, Brooklyn, NY 11203 | 2019-06-26 |
| Find all providers in zip 11203 | ||||
| Taxonomy Code | 302R00000X |
| Grouping | Managed Care Organizations |
| Classification | Health Maintenance Organization |
| (1) A form of health insurance in which its members prepay a premium for the HMO’s health services which generally include inpatient and ambulatory care. For the patient, an HMO means reduced out-of-pocket costs (i.e. no deductible), no paperwork (i.e. insurance forms), and only a small copayment for each office visit to cover the paperwork handled by the HMO; (2) A organization of health care personnel and facilities that provides a comprehensive range of health services to an enrolled population for a fixed sum of money paid in advance for a specified period of time. These health services include a wide variety of medical treatments and consults, inpatient and outpatient hospitalization, home health service, ambulance service, and sometimes dental and pharmacy services. The HMO may be organized as a group model, an individual practice association (IPA), a network model or a staff model. |
| Notes: Source: (1) Medical Interface: Managed Care A thru Z- Managed Care Terms published by Medicom International, Bronxville, New York Telephone (914) 337-5023, p. 20; (2) "Glossary of terms used in managed care" Developed by the Managed Care Assembly (MCA) of Medical Group Management Association (MGMA), MGM Journal, September/October 1995, p. 58 |
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| 1144682931 | Ocean View Optical 5 | Health Maintenance Organization | 453 Fulton St, Brooklyn, NY 11201-5207 | 2016-03-22 |
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| 1497139414 | Brooklyn Bureau of Community Services | Health Maintenance Organization | 25 Chapel St Ste 1204, Brooklyn, NY 11201-1955 | 2015-07-20 |
| 1164802765 | Fun and Function Ot P.C. | Health Maintenance Organization | 3414 Avenue K, Brooklyn, NY 11210-4145 | 2015-06-09 |
| 1902290216 | Anh Pharmacy Inc | Health Maintenance Organization | 3167 Fulton St, Brooklyn, NY 11208-1922 | 2015-03-25 |
| 1831517101 | Crj Pharmacy LLC | Health Maintenance Organization | 1341 Fulton St, Brooklyn, NY 11216-5219 | 2014-04-02 |
| Find all providers in BROOKLYN | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.