Individual provider Active NPI

Olga Tsireshkin, MD

  • Diagnostic Radiology Physician
  • Brooklyn, NY
National Provider Identifier
1164618708
Registry record updated Sep 18, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
License
197988 Issued in NY
Practice address
3044 Coney Island Ave
Suite LL
Brooklyn, NY 11235-5224
Phone
(718) 891-2100
Fax
(718) 891-3610
NPI assigned
Sep 18, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 18, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Radiology Physician 2085R0202X 197988 NY Primary

Addresses

Primary practice location

3044 Coney Island Ave
Suite LL
Brooklyn, NY 11235-5224

Mailing address

3044 Coney Island Ave
Suite LL
Brooklyn, NY 11235-5224
Phone (718) 891-2100

Other identifiers 1

IdentifierTypeStateIssuer
01663776MedicaidNY

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
I20050316000374 NY Practitioner - Diagnostic Radiology 5890740443 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Diagnostic Radiology
Education
Other, 1978
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

3140 Coney Island Ave
FL 5
Brooklyn, NY 11235-6228
Phone (718) 891-2100

Merit-based Incentive Payment System (MIPS)

Final score
0 of 100Reported as individual
Quality
0
Improvement activities
0
Cost
0

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
197988NYMDDiagnostic Radiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
21St Century Radiology and Imaging, PC Diagnostic Radiology CurrentSince Jun 1, 2003 Accepting new patients
Alexander Merson, M.D., PLLC Past Accepting new patients

Locations

3140 Coney Island Ave
Fl 5
Brooklyn, NY 11235
Phone (718) 891-2100

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": "1190073600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1190073600000",
    "number": "1164618708",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3044 CONEY ISLAND AVE",
            "address_2": "SUITE LL",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112355224",
            "telephone_number": "718-891-2100",
            "fax_number": "718-891-3610"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3044 CONEY ISLAND AVE",
            "address_2": "SUITE LL",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112355224",
            "telephone_number": "718-891-2100",
            "fax_number": "718-891-3610"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TSIRESHKIN",
        "first_name": "OLGA",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-09-18",
        "last_updated": "2007-09-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "NY",
            "license": "197988",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01663776",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Brooklyn, NY

Sources for this page

Verify at the official NPI Registry.