NPIMap

Individual provider Active NPI

Mikhail Yuryevich Korogluyev, M.D.,D.O.

  • Family Medicine Physician
  • Brooklyn, NY
National Provider Identifier
1083820252
Registry record updated Feb 27, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
252520 Issued in NY
Practice address
164 Brighton 11TH St
Brooklyn, NY 11235
Phone
(718) 407-6333
NPI assigned
May 15, 2007
Last updated
Feb 27, 2019By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 27, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 252520 NY Primary

Addresses

Primary practice location

164 Brighton 11TH St
Brooklyn, NY 11235

Mailing address

2604 National Dr
Brooklyn, NY 11234-6917
Phone (917) 873-7907

Other practice location 1

6350 Saunders St
Rego Park, NY 11374-2010
Phone (718) 275-3333

Other practice location 2

164 Brighton 11th St
Brooklyn, NY 11235
Phone (718) 407-6333

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100410000018 NY Practitioner - Osteopathic Manipulative Medicine 4082740519 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Osteopathic Manipulative Medicine
Education
New York College of Osteo Medicine of New York Institute of Technology, 2007
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

158 Brighton 11TH St
Brooklyn, NY 11235-5327
Phone (718) 407-6333

2604 National Dr
Brooklyn, NY 11234-6917

6350 Saunders St
Rego Park, NY 11374-2010
Phone (718) 275-3333

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
93.09 of 100Reported as individual
Quality
88.33
Improvement activities
40
Cost
59.18

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
252520NYMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Medical Health 4 All PC Family Medicine CurrentSince Apr 14, 2011 Accepting new patients
Pro-Health Physical Therapy Services PLLC PastSince Jul 1, 2010 Accepting new patients

Locations

164 Brighton 11th St
Brooklyn, NY 11235
Phone (718) 382-6650

158 Brighton 11th St
Brooklyn, NY 11235
Phone (718) 332-8181

Networks

  • Healthfirst Medicare Network H9678
  • Healthfirst Medicare Network H3359
  • Healthfirst Medicare Network H5989
  • Healthfirst Medicare Network H1722

Interoperability endpoints

  • Direct secure messaging: korogluyev.m@mh4a-ny.direct.office.nextgen.com
  • FHIR API: https://fhir.meditouchehr.com/api/fhir/r4/

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 9

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1179187200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1551225600000",
    "number": "1083820252",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2604 NATIONAL DR",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112346917",
            "telephone_number": "917-873-7907",
            "fax_number": "718-889-6091"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "164 BRIGHTON 11TH ST",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "11235",
            "telephone_number": "718-407-6333"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "6350 Saunders St",
            "address_purpose": "LOCATION",
            "city": "Rego Park",
            "state": "NY",
            "postal_code": "113742010",
            "country_code": "US",
            "telephone_number": "718-275-3333",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "164 Brighton 11th St",
            "address_purpose": "LOCATION",
            "city": "Brooklyn",
            "state": "NY",
            "postal_code": "11235",
            "country_code": "US",
            "telephone_number": "718-407-6333",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KOROGLUYEV",
        "first_name": "MIKHAIL",
        "middle_name": "YURYEVICH",
        "credential": "M.D.,D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-05-15",
        "last_updated": "2019-02-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NY",
            "license": "252520",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brooklyn, NY

Sources for this page

Verify at the official NPI Registry.