Evgeny Olenko, M.D.

Primary specialty

Adult Medicine PhysicianTaxonomy code 207QA0505X

License

145218 Issued in NY

Practice address

10537 64TH Ave
Forest Hills, NY 11375-1645

Phone

(718) 459-0111

Fax

(718) 896-1596

NPI assigned

Oct 31, 2006

Last updated

Jul 29, 2008By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other identifiers 1

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

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

{
    "created_epoch": "1162252800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1217289600000",
    "number": "1093891079",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "105-37 64 AVENUE",
            "city": "FOREST HILLS",
            "state": "NY",
            "postal_code": "113751645",
            "telephone_number": "718-459-0111",
            "fax_number": "718-896-1596"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10537 64TH AVE",
            "city": "FOREST HILLS",
            "state": "NY",
            "postal_code": "113751645",
            "telephone_number": "718-459-0111",
            "fax_number": "718-896-1596"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OLENKO",
        "first_name": "EVGENY",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-10-31",
        "last_updated": "2008-07-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207ZP0101X",
            "taxonomy_group": "",
            "desc": "Pathology, Anatomic Pathology",
            "state": "NY",
            "license": "145218",
            "primary": false
        },
        {
            "code": "207QA0505X",
            "taxonomy_group": "",
            "desc": "Family Medicine, Adult Medicine",
            "state": "NY",
            "license": "145218",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00736250",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Maura C Okeefe, PHYSICIAN ASSISTANT
• Nneamaka C Okoye
• Mirian E. Olaechea, MS ED
• Olawole Oladele Olafisoye, MD
• Julissa Olea
• Olga Olenko, D.D.S.
• Catherine Oliva
• Angelina Olivares, LMSW
• Brian Olivares, PT
• Neville H Oliver Jr., LCSW

• Adult Medicine Physician in Forest Hills, NY
• Providers in Forest Hills, NY by specialty
• Adult Medicine Physician in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 29, 2008; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.