PRIME CARE ON THE BAY LLC NPI 1023297694

Clinic/Center (Primary Care) in Brooklyn, NY

NPI 1023297694 Organization Clinic/Center Primary Care

About PRIME CARE ON THE BAY LLC

Prime Care On The Bay Llc is a primary care provider established in Brooklyn, New York specializing in clinic/center (primary care) . The NPI number of Prime Care On The Bay Llc is 1023297694 and was assigned on October 2007. The practitioner's primary taxonomy code is 261QP2300X with license number 7001106R (NY). The provider is registered as an organization and their NPI record was last updated 14 years ago. The authorized official of this NPI record is Dr. Eldar Kadymoff D.o. (Medical Director)

A primary care provider (PCP) like Prime Care On The Bay Llc sees people with common medical problems. The primary care provider might be a doctor, physician assistant, nurse practitioner or clinic that are usually involved in your long-term care. A PCP might provide preventive care, treat common medical conditions, identify urgent medical problems and refer you to specialists when necessary. Primary care is usually provided in an outpatient facility but if you are admitted to a hospital your PCP may assist in your care. The most common medical conditions seen by primary care providers are: hypertension, upper respiratory tract infections, depression or anxiety, back pain, arthritis, dermatitis, diabetes, urinary tract infections, etc

NPI

1023297694

Provider NamePRIME CARE ON THE BAY LLC
Provider Location Address1711 SHEEPSHEAD BAY RD GROUND FLOOR BROOKLYN, NY 11235
Provider Mailing Address1711 SHEEPSHEAD BAY RD GROUND FLOOR BROOKLYN, NY 11235
NPI Entity TypeOrganization
Is Sole Proprietor?N/A
Is Organization Subpart?No
Enumeration Date10-30-2007
Last Update Date10-31-2007


Primary Taxonomy

Taxonomy Code261QP2300X
ClassificationClinic/Center
TypeAmbulatory Health Care Facilities
SpecializationPrimary Care
License No.7001106R
License StateNY

Business Address

PRIME CARE ON THE BAY LLC
1711 SHEEPSHEAD BAY RD
GROUND FLOOR
BROOKLYN, NY
ZIP 11235
Phone: (718) 332-8002
Fax: (718) 332-8006

Get Directions


Mailing Address

PRIME CARE ON THE BAY LLC
1711 SHEEPSHEAD BAY RD
GROUND FLOOR
BROOKLYN, NY
ZIP 11235
Phone: (718) 332-8002
Fax: (718) 332-8006



Authorized Official

Authorized Official NameDR. ELDAR KADYMOFF D.O.
Authorized Official TitleMEDICAL DIRECTOR
Authorized Official Phone(718) 332-8002

Additional Identifiers


Additional identifier(s) currently or formerly used as an identifier for the provider. The codes may include UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers.

Identifier Type / Code Identifier State
02426653MEDICAID (05)NY

Other Providers at the same location


The following 5 providers are registered at the same or nearby location.

NPI Name / Type Taxonomy Address
1669466249DR. ELDAR KADYMOFF D.O.
Individual
Family Medicine1711 SHEEPSHEAD BAY RD NGM/PRIME CARE ON THE BAY
BROOKLYN, NY 11235
(718) 332-8002
1720248628MR. ERNESTO N VILLAS RPT
Individual
Specialist1711 SHEEPSHEAD BAY RD
BROOKLYN, NY 11235
(347) 495-6566
1649429929OFFICE BASED SURGERY ON THE BAY
Organization
Obstetrics & Gynecology (Gynecology)1711 SHEEPSHEAD BAY RD
BROOKLYN, NY 11235
(718) 332-5678
1962578229 JEFFREY C MARC MO
Individual
Internal Medicine1711 SHEEPSHEAD BAY RD LOVER LEVEL
BROOKLYN, NY 11235
(718) 332-7717
1750328688DR. ANNA YATSKAR M.D
Individual
Internal Medicine1711 SHEEPSHEAD BAY RD 2 FL
BROOKLYN, NY 11235
(718) 615-0014

NPI Footnotes

What is the National Provider Indentifier (NPI)?
The NPI is 10-position all-numeric identification number assigned by the NPPES to uniquely identify a health care provider.

Provider Location Address
The location address of the provider being identified. For providers with more than one physical location, this is the primary location. This address cannot include a Post Office box.

Provider Mailing Address
The mailing address of the provider being identified. This address may contain the same information as the provider location address.

Entity Type Code
The code describing the type of health care provider that is being assigned an NPI.
The entity type codes are:
1 = Person: individual human being who furnishes health care;
2 = Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)

What is a Subpart?
Subparts are the components and separate physical locations of organization health care providers. Subpart examples include:
Hospital components include outpatient departments, surgical centers, psychiatric units, and laboratories. These components are often separately licensed or certified by States and may exist at physical locations other than that of the hospital of which they are a component.

Provider Other Organization Name
The other organization name is the alternative last name by which the provider is or has been known (if an individual) or other name by which the organization provider is or has been known. The code identifying the type of other name. The provider other organization name codes are:
1 = former name;
2 = professional name;
3 = doing business as (d/b/ a) name;
4 = former legal business name; :
5 = other.

Provider Enumeration Date
The date the provider was assigned a unique identifier (assigned an NPI).

Last Update Date
The date that a NPI record was last updated or changed.

Primary Taxonomy Code
The primary taxonomy code defines the provider type, classification, and specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.

Authorized Official Name
The name of the person authorized to submit the NPI application or to officially change data for a health care provider.