Individual provider Active NPI

Ksenia Goman, MD

  • Cornea and External Diseases Specialist Physician
  • New York, NY
National Provider Identifier
1013401256
Registry record updated Aug 11, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Cornea and External Diseases Specialist PhysicianTaxonomy code 207WX0120X
License
317081 Issued in NY
Practice address
210 E 64TH St FL 7
New York, NY 10065-7471
Phone
(212) 838-9200
NPI assigned
Jun 20, 2018
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 11, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Cornea and External Diseases Specialist Physician 207WX0120X 317081 NY Primary

Addresses

Primary practice location

210 E 64TH St FL 7
New York, NY 10065-7471

Mailing address

210 E 64TH St FL 7
New York, NY 10065-7471

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
I20231024001100 NY Practitioner - Ophthalmology 7618323973 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Ophthalmology
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
North Shore-Lij Medical PCGroup PAC ID 3375701568, 6,374 clinicians

Practice addresses (Care Compare)

100 E 77TH St
New York, NY 10075-1850

111 E 77TH St
New York, NY 10075-1850
Phone (212) 434-3966

1111 Marcus Ave
New Hyde Park, NY 11042-1034

210 E 64TH St
New York, NY 10065-7471

300 Community Dr
Manhasset, NY 11030-3816

300 Community Dr LL
Manhasset, NY 11030-3816
Phone (516) 562-2229

330 Community Dr
Manhasset, NY 11030-3816
Phone (516) 708-2550

350 Community Dr
Manhasset, NY 11030-3816
Phone (516) 562-3845

440 Mamaroneck Ave
Harrison, NY 10528-2418
Phone (914) 777-8400

Hospital & facility affiliations

  • Lenox Hill Hospital Hospital, New York, NY, CCN 330119

Merit-based Incentive Payment System (MIPS)

Final score
93.07 of 100Reported as apm
Quality
79.77
Promoting interoperability
88.77
Improvement activities
40

Procedures performed for Medicare patients

ProcedureNumber of procedures
Cataract surgery147

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
317081NYMDCornea and External Diseases Specialist Physician

Practice roles

OrganizationSpecialtyStatusNew patients
North Shore-Lij Medical PC CurrentSince Oct 2, 2023 Accepting new patients

Locations

440 Mamaroneck Ave
Ste 410
Harrison, NY 10528
Phone (914) 777-8400

1111 Marcus Ave
Ste M04
New Hyde Park, NY 11042
Phone (585) 736-3650

210 E 64th St
Fl 7
New York, NY 10065
Phone (212) 434-4050

300 Community Dr
Plandome, NY 11030

Networks

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

Interoperability endpoints

  • Direct secure messaging: kdenisova861680@nychhc.direct-ci.com
  • Direct secure messaging: kgoman@northwellhealth.intellechartdirect.net
  • Direct secure messaging: kgoman69018@northwell.direct-ci.com

Organizations & group practices 1

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.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1529452800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1691712000000",
    "number": "1013401256",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "210 E 64TH ST FL 7",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100657471"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "210 E 64TH ST FL 7",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100657471",
            "telephone_number": "212-838-9200"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GOMAN",
        "first_name": "KSENIA",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-06-20",
        "last_updated": "2023-08-11",
        "certification_date": "2023-08-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207WX0120X",
            "taxonomy_group": "",
            "desc": "Ophthalmology, Cornea and External Diseases Specialist",
            "state": "NY",
            "license": "317081",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

Verify at the official NPI Registry.