Individual provider Active NPI

Sergey Galustyan, M.D.

  • Pediatric Emergency Medicine (Emergency Medicine) Physician
  • Jamaica, NY
National Provider Identifier
1053418095
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Emergency Medicine (Emergency Medicine) PhysicianTaxonomy code 207PP0204X
License
221485 Issued in NY
Practice address
8900 Van Wyck Expy
Jamaica, NY 11418-2897
Phone
(718) 206-6000
NPI assigned
Sep 20, 2006
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Emergency Medicine (Emergency Medicine) Physician 207PP0204X 221485 NY Primary

Addresses

Primary practice location

8900 Van Wyck Expy
Jamaica, NY 11418-2897

Mailing address

80 Marcus Dr
Melville, NY 11747-4230
Phone (631) 391-7700

Other identifiers 1

IdentifierTypeStateIssuer
02177053MedicaidNY

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
I20040929001070 NY Practitioner - Emergency MedicinePractitioner - Pediatric Medicine 1254300882 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Emergency Medicine
Education
Other, 1988
Medicare assignment
May accept Medicare assignment
Group practices
Optum Urgent Care PLLCGroup PAC ID 8628299518, 68 clinicians
North Shore Lij Urgent Care PCGroup PAC ID 6002131778, 389 clinicians

Practice addresses (Care Compare)

1049 Morris Park Ave
Bronx, NY 10461-1410
Phone (929) 777-9082

1436 Union Tpke
New Hyde Park, NY 11040-1761
Phone (516) 360-3631

16450 Crossbay Blvd
Howard Beach, NY 11414-3749
Phone (718) 848-8412

255 Union Turnpike
Glen Oaks, NY 11004
Phone (516) 622-6196

555 N Broadway
Jericho, NY 11753-2134
Phone (516) 597-5070

Merit-based Incentive Payment System (MIPS)

Final score
82.13 of 100Reported as group
Quality
72.13
Promoting interoperability
91
Improvement activities
40
Cost
75.81

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Optum Medical Care, P.C. CurrentSince Sep 1, 2022 Accepting new patients
Optum Urgent Care, PLLC CurrentSince Jul 24, 2018 Accepting new patients
North Shore Lij, Urgent Care, P.C. CurrentSince Dec 5, 2025 Accepting new patients
Optum Medical Care, P.C. CurrentSince Sep 1, 2022 Accepting new patients
St Lukes Roosevelt Hospital Center Past Accepting new patients

Locations

5828 99th St
Flushing, NY 11368
Phone (718) 502-9867

555 N Broadway
Jericho, NY 11753
Phone (516) 597-5070

50 E Jericho Tpke
Mineola, NY 11501
Phone (516) 399-3068

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

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

1436 Union Tpke
New Hyde Park, NY 11040
Phone (516) 360-3631

2800 Marcus Ave
New Hyde Park, NY 11042
Phone (516) 622-6131

377 S Oyster Bay Rd
Plainview, NY 11803
Phone (516) 537-9061

Philadelphia, PA 19195

Organizations & group practices 5

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1158710400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1053418095",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "80 MARCUS DR",
            "city": "MELVILLE",
            "state": "NY",
            "postal_code": "117474230",
            "telephone_number": "631-391-7700",
            "fax_number": "631-454-4161"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8900 VAN WYCK EXPY",
            "city": "JAMAICA",
            "state": "NY",
            "postal_code": "114182897",
            "telephone_number": "718-206-6000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GALUSTYAN",
        "first_name": "SERGEY",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-20",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207PP0204X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine, Pediatric Emergency Medicine",
            "state": "NY",
            "license": "221485",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02177053",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Jamaica, NY

Sources for this page

Verify at the official NPI Registry.