Individual provider Active NPI

Lyudmila Shtein, DO

  • Family Medicine Physician
  • Brooklyn, NY
National Provider Identifier
1013297118
Registry record updated Oct 17, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
259564 Issued in NY
Practice address
1068 Coney Island Ave
Brooklyn, NY 11230-2303
Phone
(718) 684-1760
Fax
(718) 684-1757
NPI assigned
Aug 19, 2011
Last updated
Oct 17, 2017By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 17, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 259564 NY Primary

Addresses

Primary practice location

1068 Coney Island Ave
Brooklyn, NY 11230-2303

Mailing address

352 52ND St
Brooklyn, NY 11220-1810
Phone (718) 684-1760

Other names 1

  • Lyudmila Tkachenkova Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20120703000153 NY Practitioner - Family PracticePractitioner - Osteopathic Manipulative Medicine 4183889892 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family PracticeAlso: Osteopathic Manipulative Medicine
Education
New York College of Osteo Medicine of New York Institute of Technology, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

1068 Coney Island Ave
Brooklyn, NY 11230-2303
Phone (718) 684-1760

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of tissue1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

State licenses

LicenseStateTypeSpecialty
259564NYMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Dr. Shtein Medical P.C. Family Medicine CurrentSince Jan 2, 2018 Accepting new patients
Benson Medical Imaging PLLC Past Accepting new patients

Locations

1068 Coney Island Ave
Brooklyn, NY 11230
Phone (718) 684-1760

Networks

  • Healthfirst Medicare Network H5989
  • Healthfirst Medicare Network H1722
  • Healthfirst Medicare Network H9678
  • Healthfirst Medicare Network H3359

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1313712000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1508198400000",
    "number": "1013297118",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "352 52ND ST",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112201810",
            "telephone_number": "718-684-1760",
            "fax_number": "718-684-1757"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1068 CONEY ISLAND AVE",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112302303",
            "telephone_number": "718-684-1760",
            "fax_number": "718-684-1757"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHTEIN",
        "first_name": "LYUDMILA",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-08-19",
        "last_updated": "2017-10-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NY",
            "license": "259564",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "LYUDMILA",
            "last_name": "TKACHENKOVA",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Brooklyn, NY

Sources for this page

Verify at the official NPI Registry.