NPIMap

Organization Active NPI

Vladimir Zelenko M.D. P.C.

  • Family Medicine Physician
  • Monroe, NY
National Provider Identifier
1063669562
Registry record updated Sep 7, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
VLADIMIR ZELENKO M.D. P.C.
Practice address
3 Hamaspik Way
Monroe, NY 10950-8600
Phone
(845) 782-0000
Fax
(845) 205-4690
NPI assigned
Aug 26, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 7, 2022

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

Authorized official

Name
Dr. Jonathan Gamss, MDNPI 1598922874
Title
MD
Phone
(845) 662-2404

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
Family Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207Q00000X Primary

Addresses

Primary practice location

3 Hamaspik Way
Monroe, NY 10950-8600

Mailing address

3 Hamaspik Way Unit 11
Monroe, NY 10950-8625
Phone (845) 782-0000

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20090605000174 NY Part B Supplier - Clinic/Group Practice 4587714985 Receives reassigned benefits from 14 practitioners
Practice locations: Monroe, NY

National Provider Directory

National Provider Directory

Locations

745 State Route 17M
Ste 770
Monroe, NY 10950

48 Bakertown Rd
#206D
Monroe, NY 10950
Phone (845) 792-0000

Practitioners & affiliated clinicians

Practitioners 14

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 14

NPI Registry JSON

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

{
    "created_epoch": "1219708800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1662508800000",
    "number": "1063669562",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3 HAMASPIK WAY UNIT 11",
            "city": "MONROE",
            "state": "NY",
            "postal_code": "109508625",
            "telephone_number": "845-782-0000",
            "fax_number": "845-205-4690"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3 HAMASPIK WAY",
            "city": "MONROE",
            "state": "NY",
            "postal_code": "109508600",
            "telephone_number": "845-782-0000",
            "fax_number": "845-205-4690"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VLADIMIR ZELENKO M.D. P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-08-26",
        "last_updated": "2022-09-07",
        "certification_date": "2022-09-07",
        "status": "A",
        "authorized_official_last_name": "GAMSS",
        "authorized_official_first_name": "JONATHAN",
        "authorized_official_title_or_position": "MD",
        "authorized_official_telephone_number": "845-662-2404",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Monroe, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 7, 2022; 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.