Individual provider Active NPI

Luiza Guseynov, M.D.

  • Family Medicine Physician
  • Bronx, NY
National Provider Identifier
1114994134
Registry record updated Apr 30, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
233370 Issued in NY
Practice address
3108 Kingsbridge Ave
Office B
Bronx, NY 10463-3956
Phone
(718) 432-0200
NPI assigned
Mar 8, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 30, 2012

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 233370 NY Primary

Addresses

Primary practice location

3108 Kingsbridge Ave
Office B
Bronx, NY 10463-3956

Mailing address

168-32 Powells Cove Blvd
Beechhurst, NY 11357-1523
Phone (917) 841-4129

Other identifiers 1

IdentifierTypeStateIssuer
02625643MedicaidNY

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
I20050110001005 NY Practitioner - Family Practice 0648228270 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 1982
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

3108 Kingsbridge Ave
Ofc B
Bronx, NY 10463-3956
Phone (718) 432-0200

Hospital & facility affiliations

  • Americare Certified Special Services, Inc Chha Home health agency, Brooklyn, NY, CCN 337290

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
233370NYMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Luiza Guseynov,Physician,PLLC CurrentSince Sep 1, 2010 Accepting new patients
SVS Wellcare Medical PLLC Past Accepting new patients
Maspeth Roura Medical Care PC Past Accepting new patients
Pro-Health Physical Therapy Services PLLC Past Accepting new patients
A Podiatric Care PC Past Accepting new patients
Oksa Medical PC Family Medicine PastSince Jun 1, 2004 Accepting new patients
SZS Medical Care PLLC Past Accepting new patients
Ib Family Medical PC Family Medicine Past Accepting new patients
Provider Medical Care PC Family Medicine Past Accepting new patients
Intermed Care PC Past Accepting new patients
Collins Wellcare Medical, P.C. Past Accepting new patients

Locations

3108 Kingsbridge Ave
Ofc B
Bronx, NY 10463
Phone (718) 432-0200

3108 Kingsbridge Ave
#B
Bronx, NY 10463
Phone (718) 432-0200

3108 Kingsbridge Ave
Ste 1B
Bronx, NY 10463
Phone (718) 884-8181

3108 Kingsbridge Ave
Ste B
Bronx, NY 10463
Phone (718) 432-0200

Networks

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

Organizations & group practices 11

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.

Hospital & facility affiliations 1

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": "1141776000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1335744000000",
    "number": "1114994134",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "168-32 POWELLS COVE BLVD",
            "city": "BEECHHURST",
            "state": "NY",
            "postal_code": "113571523",
            "telephone_number": "917-841-4129"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3108 KINGSBRIDGE AVE",
            "address_2": "OFFICE B",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "104633956",
            "telephone_number": "718-432-0200"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GUSEYNOV",
        "first_name": "LUIZA",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-03-08",
        "last_updated": "2012-04-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NY",
            "license": "233370",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02625643",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Bronx, NY

Sources for this page

Verify at the official NPI Registry.