Individual provider Active NPI

Tibor Gershkovich, MD

  • Pediatrics Physician
  • Brooklyn, NY
National Provider Identifier
1033203070
Registry record updated Nov 7, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
205590 Issued in NY
Practice address
7901 Bay Pkwy
Brooklyn, NY 11214-1955
Phone
(718) 234-3558
Fax
(718) 234-3644
NPI assigned
Oct 3, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 7, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 205590 NY Primary

Addresses

Primary practice location

7901 Bay Pkwy
Brooklyn, NY 11214-1955

Mailing address

7901 Bay Pkwy
Brooklyn, NY 11214-1955
Phone (718) 234-3558

Other identifiers 1

IdentifierTypeStateIssuer
01733733MedicaidNY

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
I20161107000504 NY Practitioner - Pediatric Medicine 7214215680 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Pediatric Medicine
Education
Other, 1976
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

7901 Bay Pkwy
Brooklyn, NY 11214-1955
Phone (718) 234-3558

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
205590NYMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Gershkovich Medicine, PC Pediatrics CurrentSince Aug 17, 2016 Accepting new patients
Maimonides Medical Center Current Accepting new patients
Gershkovich Medicine, PC Pediatrics PastSince Aug 17, 2016 Accepting new patients

Locations

7901 Bay Pkwy
Brooklyn, NY 11214
Phone (718) 234-3558

Networks

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

Interoperability endpoints

  • Direct secure messaging: tiborgershkovich@mai.allscriptsdirect.net

Organizations & group practices 3

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": "1159833600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1383782400000",
    "number": "1033203070",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7901 BAY PKWY",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112141955",
            "telephone_number": "718-234-3558",
            "fax_number": "718-234-3644"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7901 BAY PKWY",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112141955",
            "telephone_number": "718-234-3558",
            "fax_number": "718-234-3644"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GERSHKOVICH",
        "first_name": "TIBOR",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-10-03",
        "last_updated": "2013-11-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "NY",
            "license": "205590",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01733733",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Brooklyn, NY

Sources for this page

Verify at the official NPI Registry.