NPIMap

Organization Active NPI

Org Medical PLLC

  • Pain Medicine (Anesthesiology) Physician
  • Brooklyn, NY
National Provider Identifier
1053583682
Registry record updated Mar 24, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pain Medicine (Anesthesiology) PhysicianTaxonomy code 207LP2900X
License
9K5581 Issued in NY
Legal business name
ORG MEDICAL PLLC
Practice address
99 Moore St
Unit 1- Z
Brooklyn, NY 11206-3302
Phone
(917) 538-9844
NPI assigned
Mar 24, 2008
Last updated
Mar 24, 2008By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 24, 2008

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

Authorized official

Name
Mrs. Olga Tyuleneva, M.D.NPI 1235123597
Title
Medical Director
Phone
(917) 538-9844

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pain Medicine (Anesthesiology) Physician 207LP2900X 9K5581 NY Primary

Addresses

Primary practice location

99 Moore St
Unit 1- Z
Brooklyn, NY 11206-3302

Mailing address

99 Moore St
Unit 1- Z
Brooklyn, NY 11206-3302
Phone (917) 538-9844

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20080519000726 NY Part B Supplier - Clinic/Group Practice 7315016250 Receives reassigned benefits from 12 practitioners
Practice locations: Brooklyn, NY; Jamaica, NY

National Provider Directory

National Provider Directory

Locations

99 Moore St
Ste 1
Brooklyn, NY 11206
Phone (718) 687-2010

Practitioners & affiliated clinicians

Practitioners 31

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 31

NPI Registry JSON

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

{
    "created_epoch": "1206316800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1206316800000",
    "number": "1053583682",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "99 MOORE ST",
            "address_2": "UNIT 1- Z",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112063302",
            "telephone_number": "917-538-9844"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "99 MOORE ST",
            "address_2": "UNIT 1- Z",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112063302",
            "telephone_number": "917-538-9844"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ORG MEDICAL PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-03-24",
        "last_updated": "2008-03-24",
        "status": "A",
        "authorized_official_last_name": "TYULENEVA",
        "authorized_official_first_name": "OLGA",
        "authorized_official_title_or_position": "MEDICAL DIRECTOR",
        "authorized_official_telephone_number": "917-538-9844",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207LP2900X",
            "taxonomy_group": "",
            "desc": "Anesthesiology, Pain Medicine",
            "state": "NY",
            "license": "9K5581",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brooklyn, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 24, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.