Individual provider Active NPI

Vikhta Gurevich, M.D.

  • Psychiatry Physician
  • Brooklyn, NY
National Provider Identifier
1164511218
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
162543-1 Issued in NY
Practice address
307 Oceanview Ave
Brooklyn, NY 11235
Phone
(718) 743-5555
NPI assigned
Oct 12, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 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 162543-1 NY Primary

Addresses

Primary practice location

307 Oceanview Ave
Brooklyn, NY 11235

Mailing address

22 Edgemere Dr
Albertson, NY 11507-1030
Phone (516) 625-0647

Other identifiers 1

IdentifierTypeStateIssuer
01539624MedicaidNY

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
I20070108000415 NY Practitioner - Psychiatry 3173523842 Reassigns benefits to 2 organizations
Practice locations: Brooklyn, NY; Far Rockaway, NY

Care Compare profile

Medicare Care Compare
Specialty
Psychiatry
Education
Other, 1972
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
New Horizon Counseling Center IncGroup PAC ID 4880681295, 87 clinicians

Practice addresses (Care Compare)

108 -19 Rockaway Blvd
Ozone Park, NY 11420-1034

10819 Rockaway Blvd
South Ozone Park, NY 11420-1034
Phone (718) 845-2620

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
162543-1NYMDPsychiatry Physician

Practice roles

OrganizationSpecialtyStatusNew patients
New Horizon Counseling Center Inc CurrentSince Feb 16, 2019 Accepting new patients
Catholic Charities Neighborhood Services, Inc. CurrentSince Oct 14, 2018 Accepting new patients
Catholic Charities Neigborhood Services Past Accepting new patients
Jewish Board of Family and Children'S Services, Inc. Past Accepting new patients
Jewish Board for Family and Children Services Past Accepting new patients
Catholic Charities Neigborhood Services PastSince Nov 10, 2019 Accepting new patients

Locations

1623 Flatbush Ave
Brooklyn, NY 11210
Phone (718) 377-5755

191 Joralemon St
Fl 11
Brooklyn, NY 11201

445 Oak St
Copiague, NY 11726
Phone (631) 257-5173

1329 Beach Channel Dr
Far Rockaway, NY 11691
Phone (718) 337-6800

6729 Myrtle Ave
Glendale, NY 11385
Phone (718) 456-7001

10819 Rockaway Blvd
South Ozone Park, NY 11420
Phone (718) 327-7202

Organizations & group practices 6

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": "1160611200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1164511218",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "22 EDGEMERE DR",
            "city": "ALBERTSON",
            "state": "NY",
            "postal_code": "115071030",
            "telephone_number": "516-625-0647"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "307 OCEANVIEW AVE",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "11235",
            "telephone_number": "718-743-5555"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GUREVICH",
        "first_name": "VIKHTA",
        "name_prefix": "Mrs.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-10-12",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "NY",
            "license": "162543-1",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01539624",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Brooklyn, NY

Sources for this page

Verify at the official NPI Registry.