Individual provider Active NPI

Irina Martynova, M.D.

  • Psychiatry Physician
  • Harrison, NY
National Provider Identifier
1174558787
Registry record updated Sep 8, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
207190-1 Issued in NY
Practice address
275 North St
Harrison, NY 10528-1524
Phone
(914) 925-5277
NPI assigned
Jul 12, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 8, 2008

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 207190-1 NY Primary

Addresses

Primary practice location

275 North St
Harrison, NY 10528-1524

Mailing address

275 North St
Harrison, NY 10528-1524
Phone (914) 925-5277

Other identifiers 1

IdentifierTypeStateIssuer
01890179MedicaidNY

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
I20081203000006 NY Practitioner - Psychiatry 1850452376 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Psychiatry
Education
Other, 1982
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

275 N St
Harrison, NY 10528-1140
Phone (914) 715-8164

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
207190-1NYMDPsychiatry Physician

Practice roles

OrganizationSpecialtyStatusNew patients
St.Vincent' Hospital Westchester Psych CurrentSince Nov 30, 2011 Accepting new patients
St. Joseph'S Hospital Yonkers Current Accepting new patients
St Josephs Hospital Yonkers CurrentSince Nov 30, 2011 Accepting new patients
Comprehensive Psychiatry PC Psychiatry CurrentSince Jul 26, 2011 Accepting new patients

Locations

275 North St
Harrison, NY 10528
Phone (914) 925-5211

Networks

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

Organizations & group practices 4

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": "1152662400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1220832000000",
    "number": "1174558787",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "275 NORTH ST",
            "city": "HARRISON",
            "state": "NY",
            "postal_code": "105281524",
            "telephone_number": "914-925-5277"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "275 NORTH ST",
            "city": "HARRISON",
            "state": "NY",
            "postal_code": "105281524",
            "telephone_number": "914-925-5277"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARTYNOVA",
        "first_name": "IRINA",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-07-12",
        "last_updated": "2008-09-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "NY",
            "license": "207190-1",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01890179",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Harrison, NY

Sources for this page

Verify at the official NPI Registry.