Individual provider Active NPI

Sergei Belkin, MD

  • Psychiatry Physician
  • Glen Cove, NY
National Provider Identifier
1083609762
Registry record updated Oct 12, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
225163 Issued in NY
Practice address
15 Glen St
Ste 304
Glen Cove, NY 11542-2782
Phone
(516) 671-6021
NPI assigned
Sep 19, 2005
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 12, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician 2084P0800X 225163 NY Primary

Addresses

Primary practice location

15 Glen St
Ste 304
Glen Cove, NY 11542-2782

Mailing address

15 Glen St
Ste 304
Glen Cove, NY 11542-2782

Other identifiers 1

IdentifierTypeStateIssuer
02362765MedicaidNY

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
I20040515000331 NY Practitioner - Psychiatry 5193715712 Reassigns benefits to 1 organization
Practice locations: Bayside, NY; Glen Cove, NY

Care Compare profile

Medicare Care Compare
Specialty
Psychiatry
Education
Other, 1984
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

15 Glen St
Suite 304
Glen Cove, NY 11542-2782
Phone (516) 671-6021

Merit-based Incentive Payment System (MIPS)

Final score
77.83 of 100Reported as group
Quality
47.97
Improvement activities
40
Cost
63.92

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
225163NYMDPsychiatry Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Medical Care of L.I., P.C, CurrentSince Mar 8, 2010 Accepting new patients
Phoenix Houses of Long Island, Inc. PastSince Jan 24, 2021 Accepting new patients

Locations

4241 201st St
Flushing, NY 11361
Phone (516) 599-5688

15 Glen St
Ste 304
Glen Cove, NY 11542
Phone (516) 671-6021

Organizations & group practices 2

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": "1127088000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1192147200000",
    "number": "1083609762",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15 GLEN ST",
            "address_2": "STE 304",
            "city": "GLEN COVE",
            "state": "NY",
            "postal_code": "115422782"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15 GLEN ST",
            "address_2": "STE 304",
            "city": "GLEN COVE",
            "state": "NY",
            "postal_code": "115422782",
            "telephone_number": "516-671-6021"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BELKIN",
        "first_name": "SERGEI",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-09-19",
        "last_updated": "2007-10-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "NY",
            "license": "225163",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02362765",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Glen Cove, NY

Sources for this page

Verify at the official NPI Registry.