Individual provider Active NPI

Tina Urpanishvili, M.D.

  • Internal Medicine Physician
  • New York, NY
National Provider Identifier
1033359757
Registry record updated Apr 11, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
262250 Issued in NY
Practice address
96 E 4TH St
New York, NY 10003-9001
Phone
(347) 685-4007
Fax
(347) 625-6252
NPI assigned
Feb 21, 2009
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 11, 2017

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 262250 NY Primary
Geriatric Medicine (Internal Medicine) Physician 207RG0300X 262250 NY

Addresses

Primary practice location

96 E 4TH St
New York, NY 10003-9001

Mailing address

96 E 4TH St
New York, NY 10003-9001
Phone (347) 685-4007

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
I20111027000153 NY Practitioner - Internal MedicinePractitioner - Geriatric Medicine 7618140245 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

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

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
262250NYMDGeriatric Medicine (Internal Medicine) Physician

Practice roles

OrganizationSpecialtyStatusNew patients
North Shore-Lij Medical PC Internal Medicine CurrentSince Dec 16, 2022 Accepting new patients
Kingsbrook Medical Associates, PC Past Accepting new patients
Kingsbrook Medical Associates PC Past Accepting new patients

Locations

111 E 210th St
Bronx, NY 10467

300 Community Dr
Plandome, NY 11030

701 N Broadway
Sleepy Hollow, NY 10591
Phone (914) 366-3140

Interoperability endpoints

  • Direct secure messaging: tinaurpanishvili@nslijmedgr.allscriptsdirect.net

Organizations & group practices 4

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": "1235174400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1491868800000",
    "number": "1033359757",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "96 E 4TH ST",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100039001",
            "telephone_number": "347-685-4007",
            "fax_number": "347-625-6252"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "96 E 4TH ST",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100039001",
            "telephone_number": "347-685-4007",
            "fax_number": "347-625-6252"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "URPANISHVILI",
        "first_name": "TINA",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2009-02-21",
        "last_updated": "2017-04-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NY",
            "license": "262250",
            "primary": true
        },
        {
            "code": "207RG0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Geriatric Medicine",
            "state": "NY",
            "license": "262250",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

Verify at the official NPI Registry.