FIVE CREST MEDICAL DIAGNOSTIC P.C.
NPI 1104378058
Specialist in Brooklyn, NY
About Five Crest Medical Diagnostic P.c. NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
FIVE CREST MEDICAL DIAGNOSTIC P.C. (NPI 1104378058) is a healthcare organization registered as a specialist in Brooklyn, New York and active in the NPI registry since October 2016. The organization lists Sonia Walker, Medical Director, as its authorized official.
NPPES Registry Identity
Specialties & Licenses
Group Practice 1
Medicare Participation & PECOS CMS
Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.
Medicare Enrollment Status
Enrolled in Medicare (PECOS)
Five Crest Medical Diagnostic P.c. is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Clinicians Billing Medicare Through This Organization
3Medicare enrollment records show 3 clinicians reassign Medicare billing to Five Crest Medical Diagnostic P.C., which bills Medicare for the services they deliver. They are listed nearest first.
Clinicians, nearest first (3)
Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
Frequently Asked Questions NPPES & CMS
Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.
What is Five Crest Medical Diagnostic P.C.'s NPI number?
The NPI number for Five Crest Medical Diagnostic P.C. is 1104378058. It was assigned to this organization in the NPPES registry on October 26, 2016.
Where is Five Crest Medical Diagnostic P.C. located?
Five Crest Medical Diagnostic P.C. is located at 124 Bay Ridge Ave, Brooklyn, NY 11220. The listed phone number is (718) 836-2199.
What is Five Crest Medical Diagnostic P.C.'s specialty?
The primary specialty registered for this NPI is Specialist with taxonomy code 174400000X.
Is Five Crest Medical Diagnostic P.C. enrolled in Medicare?
Yes. Five Crest Medical Diagnostic P.C. is registered in the Medicare PECOS enrollment system.
How many clinicians bill Medicare through Five Crest Medical Diagnostic P.C.?
According to the CMS Revalidation Reassignment List (October 2026 release), 3 clinicians reassign their Medicare billing to Five Crest Medical Diagnostic P.C., in Allergy/Immunology, Cardiovascular Disease (Cardiology) and Diagnostic Radiology. A reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for the clinician's services. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
When was this NPI record last updated?
The NPPES record for Five Crest Medical Diagnostic P.C. was last updated on July 6, 2017. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 9 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.
# Five Crest Medical Diagnostic P.c. · NPI 1104378058
Specialist organization in Brooklyn, New York. Organization record, active in the CMS NPPES registry since October 26, 2016.
## Identity
- **NPI:** 1104378058 (Entity type: Organization)
- **Enumerated:** October 26, 2016
- **Primary specialty:** Specialist · taxonomy 174400000X
- **Organization subpart:** No
- **Authorized official:** Sonia Walker, MEDICAL DIRECTOR
## Practice location
- **Address:** 124 BAY RIDGE AVE, Brooklyn, NY 11220-5109
- **Phone:** (718) 836-2199
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Clinicians billing through this organization:** 3 clinicians in 3 Medicare specialties reassign Medicare billing to this organization (form CMS-855R); largest: Allergy/Immunology (1), Cardiovascular Disease (Cardiology) (1), Diagnostic Radiology (1) · CMS Revalidation Reassignment List, October 2026 release
## Record status
- **NPPES last updated:** July 6, 2017
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Source: [NPI Profile](https://npiprofile.com/npi/1104378058) · Data from the CMS NPPES public registry.