Tetyana Koulikova, PHYSICIAN ASSISTANT

Primary specialty

Surgery PhysicianTaxonomy code 208600000X

License

019051 Issued in NY

Practice address

2272 63Rd St Apt 2F
Brooklyn, NY 11204-3153

Phone

(929) 441-0536

NPI assigned

Sep 20, 2015

Sex

Female

Sole proprietor

No

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

Specialties & licenses 3

Addresses

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: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Physician Assistant

Education

Other, 2015

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Physician Affiliate Group of New York PCGroup PAC ID 4688098833, 1,222 clinicians

New York City Health and Hospitals CorporationGroup PAC ID 4183535305, 543 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• South Brooklyn Health Hospital, Brooklyn, NY, CCN 330196

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

Practice roles

Locations

Networks

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

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.

• New York City Health and Hospitals Corporation

  • Clinic/Center
  • New York, NY
  • NPI 1548208127
  Medicare reassignment Care Compare group
• Physician Affiliate Group of New York PC

  • Registered Dietitian
  • New York, NY
  • NPI 1013375526
  Medicare reassignment Care Compare group
• Amboy Medical Practice PC

  • Internal Medicine Physician
  • Staten Island, NY
  • NPI 1700037975
  Medicare reassignment
• New York Community Hospital of Brooklyn Inc

  • Psychiatric Hospital Unit
  • Brooklyn, NY
  • NPI 1508377334
  Medicare reassignment
• New York City Health and Hospitals Corporation

  • Clinic/Center
  • New York, NY
  • NPI 1538943469
  NPD
• New York City Health and Hospitals Corporation

  • Skilled Nursing Facility
  • New York, NY
  • NPI 1679581607
  NPD
• Marianna Blokh DPM, P.C.

  • Podiatrist
  • Brooklyn, NY
  • NPI 1497268411
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• New York City Health and Hospitals Corporation

  • General Acute Care Hospital
  • Brooklyn, NY
  • NPI 1124032982
  Care Compare affiliation

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

{
    "created_epoch": "1442707200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1567468800000",
    "number": "1174992184",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2272 63RD ST APT 2F",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112043153",
            "telephone_number": "929-441-0536"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2272 63RD ST APT 2F",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112043153",
            "telephone_number": "929-441-0536"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3319 Kings Hwy Apt 1J",
            "address_purpose": "LOCATION",
            "city": "Brooklyn",
            "state": "NY",
            "postal_code": "112342622",
            "country_code": "US",
            "telephone_number": "718-676-4067",
            "fax_number": "718-676-4068",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2525 Kings Hwy",
            "address_purpose": "LOCATION",
            "city": "Brooklyn",
            "state": "NY",
            "postal_code": "112291705",
            "country_code": "US",
            "telephone_number": "718-692-5300",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KOULIKOVA",
        "first_name": "TETYANA",
        "credential": "PHYSICIAN ASSISTANT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-09-20",
        "last_updated": "2019-09-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RH0003X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Hematology & Oncology",
            "state": "NY",
            "license": "019051",
            "primary": false
        },
        {
            "code": "208800000X",
            "taxonomy_group": "",
            "desc": "Urology",
            "state": "NY",
            "license": "019051",
            "primary": false
        },
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "NY",
            "license": "019051",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Marianthi Kougentakis
• Golnoush Kouhihabibidehkordi, MD
• Irina Koukharenko, M.D.
• Chaman Lal Koul, DDS
• Diana Koulikova, LCSW
• Michael Antonis Koullias
• Panayiotis Koumas, DO
• Danute Kounigelis, LCSW
• Inna Kouperman, MPT
• Dhihum Kour

• Surgery Physician in Brooklyn, NY
• Providers in Brooklyn, NY by specialty
• Surgery Physician in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 3, 2019; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.