Individual provider Active NPI

Galyna Fetsak

  • Obstetrics & Gynecology Physician
  • Mineola, NY
National Provider Identifier
1013398684
Registry record updated Sep 24, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X
License
298260-1 Issued in NY
Practice address
259 1St St
Dept of Obs & GYN, North Pavilion-Lower Level
Mineola, NY 11501-3957
Phone
(516) 663-8660
Fax
(516) 663-7821
NPI assigned
Jun 9, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 24, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics & Gynecology Physician 207V00000X 298260-1 NY Primary

Addresses

Primary practice location

259 1St St
Dept of Obs & GYN, North Pavilion-Lower Level
Mineola, NY 11501-3957

Mailing address

366 Onderdonk Ave Apt 3R
Ridgewood, NY 11385-1323
Phone (646) 886-9038

Other names 1

  • Galyna Cyrmachevska Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NJ
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
I20201021001683 NJ Practitioner - Obstetrics/Gynecology 9830519354 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
298260-1NYMDObstetrics & Gynecology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Practice Associates Medical Group Obstetrics & Gynecology CurrentSince Oct 6, 2020 Accepting new patients
Ahs Hospital Corp. Past Accepting new patients

Locations

100 Madison Ave
Morristown, NJ 07960
Phone (973) 538-5210

465 South St
Ste 200
Morristown, NJ 07960
Phone (973) 971-7130

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1433808000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1569283200000",
    "number": "1013398684",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "366 ONDERDONK AVE APT 3R",
            "city": "RIDGEWOOD",
            "state": "NY",
            "postal_code": "113851323",
            "telephone_number": "646-886-9038"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "259 1ST ST",
            "address_2": "DEPT OF OBS & GYN, NORTH PAVILION-LOWER LEVEL",
            "city": "MINEOLA",
            "state": "NY",
            "postal_code": "115013957",
            "telephone_number": "516-663-8660",
            "fax_number": "516-663-7821"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FETSAK",
        "first_name": "GALYNA",
        "name_prefix": "Mrs.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-06-09",
        "last_updated": "2019-09-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "NY",
            "license": "298260-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "GALYNA",
            "last_name": "CYRMACHEVSKA",
            "credential": "M.D.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Mineola, NY

Sources for this page

Verify at the official NPI Registry.