NPIMap

Individual provider Active NPI

Semyon Gurgov, M.D.

  • Urology Physician
  • Greenlawn, NY
National Provider Identifier
1023364643
Registry record updated Sep 17, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Urology PhysicianTaxonomy code 208800000X
License
292786 Issued in NY
Practice address
5 Cuba Hill Rd
Greenlawn, NY 11740-1624
Phone
(631) 628-5000
Fax
(631) 628-5715
NPI assigned
Aug 1, 2012
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 17, 2019

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Urology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 208800000X 292786 NY Primary

Addresses

Primary practice location

5 Cuba Hill Rd
Greenlawn, NY 11740-1624

Mailing address

1 Brookdale PLZ
Brooklyn, NY 11212-3139
Phone (718) 240-5000

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20180417001779 NY Practitioner - Urology 4183987548 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Urology
Education
Other, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Optum Medical Care PC 1,013 clinicians

Practice addresses (Care Compare)

90 S Bedford Rd
Mount Kisco, NY 10549-3412
Phone (914) 241-1050

Hospital & facility affiliations

  • NYU Langone Hospitals Hospital, New York, NY, CCN 330214

Procedures performed for Medicare patients

ProcedureNumber of procedures
Prostate resection19

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
292786NYMDUrology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Optum Medical Care, P.C. Multi-Specialty CurrentSince Sep 1, 2022 Accepting new patients
North Shore Medical Group of the Mount Sinai School of Medicine Multi-Specialty CurrentSince May 1, 2018 Accepting new patients
North Shore Medical Group of the Mount Sinai School of Medicine Multi-Specialty CurrentSince May 1, 2018 Accepting new patients
Optum Medical Care, P.C. CurrentSince Sep 1, 2022 Accepting new patients
North Shore Medical Group of the Mount Sinai School of Medicine Multi-Specialty Current Accepting new patients
Optum Urgent Care, PLLC Multi-Specialty Past Accepting new patients
Mount Kisco Medical Group Multi-Specialty Past Accepting new patients

Locations

5 Cuba Hill Rd
Greenlawn, NY 11740
Phone (631) 628-5000

325 Park Ave
Huntington, NY 11743
Phone (631) 351-3700

775 Park Ave
Huntington, NY 11743
Phone (631) 396-1595

90 S Bedford Rd
Mount Kisco, NY 10549
Phone (914) 242-1050

110 S Bedford Rd
Mount Kisco, NY 10549
Phone (763) 910-9192

59 Southern Blvd
Nesconset, NY 11767
Phone (631) 628-5000

Philadelphia, PA 19195

Organizations & group practices 7

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 7

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": "1343779200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1568678400000",
    "number": "1023364643",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 BROOKDALE PLZ",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112123139",
            "telephone_number": "718-240-5000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5 CUBA HILL RD",
            "city": "GREENLAWN",
            "state": "NY",
            "postal_code": "117401624",
            "telephone_number": "631-628-5000",
            "fax_number": "631-628-5715"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GURGOV",
        "first_name": "SEMYON",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2012-08-01",
        "last_updated": "2019-09-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "208800000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Urology",
            "state": "NY",
            "license": "292786",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Greenlawn, NY

Sources for this page

Verify at the official NPI Registry.