Bella Kachkoff Zubkov, MD

Primary specialty

Dermatology PhysicianTaxonomy code 207N00000X

License

035174 Issued in CT

Practice address

210 New London Tpke
Glastonbury, CT 06033-2235

Phone

(860) 633-1543

Fax

(860) 659-9755

NPI assigned

Aug 23, 2005

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 4

Medicare fee-for-service enrollment

Enrolled in CT

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

Specialty

Dermatology

Education

State University of New York at Buffalo School of Medicine, 1992

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Dermatology Associates of Glastonbury LLCGroup PAC ID 2769373372, 5 clinicians

Practice addresses (Care Compare)

Merit-based Incentive Payment System (MIPS)

Final score

75 of 100Reported as group

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

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.

• Dermatology Associates of Glastonbury LLC

  • Dermatology Physician
  • Glastonbury, CT
  • NPI 1730175845
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1124755200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1617148800000",
    "number": "1083607386",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "210 NEW LONDON TPKE",
            "city": "GLASTONBURY",
            "state": "CT",
            "postal_code": "060332235",
            "telephone_number": "860-633-1543",
            "fax_number": "860-659-9755"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "210 NEW LONDON TPKE",
            "city": "GLASTONBURY",
            "state": "CT",
            "postal_code": "060332235",
            "telephone_number": "860-633-1543",
            "fax_number": "860-659-9755"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ZUBKOV",
        "first_name": "BELLA",
        "middle_name": "KACHKOFF",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-08-23",
        "last_updated": "2021-03-31",
        "certification_date": "2021-03-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "CT",
            "license": "035174",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CONNECTICARE",
            "identifier": "035174",
            "state": "CT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM BC/BS",
            "identifier": "010035174CT01",
            "state": "CT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CIGNA",
            "identifier": "290564002",
            "state": "CT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "602454",
            "state": "CT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Dawn M Zeruk, LCSW
• Steven J Zimbel, MSW LCSW DCSW
• Katherine Zimmerli
• Diana Zitserman, N.D., L.AC.
• Robert L Zondervan
• Albert Zucchetto, MSN, NP-C
• Marlee Zyskowski, OTR/L

• Dermatology Physician in Glastonbury, CT
• Providers in Glastonbury, CT by specialty
• Dermatology Physician in Connecticut

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 31, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.