Active NPI
Tatyana M. Ledovsky, M.D.
- Pediatrics Physician
- Ridgewood, NY
National Provider Identifier
1184657967
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatrics Physician
- License
- 214455
- Practice address
- 6415 Fresh Pond Rd
Ridgewood, NY 11385-3330 - Phone
- (718) 381-9500
- Fax
- (718) 381-9505
- NPI assigned
- Jul 8, 2006
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatrics Physician | 208000000X | 214455 | NY | Primary |
| Pediatric Emergency Medicine (Pediatrics) Physician | 2080P0204X | 214455 | NY |
Addresses
Primary practice location
6415 Fresh Pond Rd
Ridgewood, NY 11385-3330
Mailing address
6415 Fresh Pond Rd
Ridgewood, NY 11385-3330
Phone (718) 381-9500
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 01980065 | Medicaid | NY |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 214455 | NY | MD | Pediatric Emergency Medicine (Pediatrics) Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Wyckoff Heights Medical Center | Current | Accepting new patients | |
| Mount Sinai School of Medicine | Past | Accepting new patients |
Networks
- Healthfirst Medicare Network H9678
- Healthfirst Medicare Network H5989
- Healthfirst Medicare Network H1722
- Healthfirst Medicare Network H3359
Interoperability endpoints
- tatyanaledovsky@whmc.allscriptsdirect.net
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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
- General Acute Care Hospital
- Brooklyn, NY
- NPI 1700886322
-
dba Mount Sinai Elmhurst Faculty Practice Group
- Internal Medicine Physician
- Elmhurst, NY
- NPI 1013147313
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1152316800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1303084800000",
"number": "1184657967",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "6415 FRESH POND RD",
"city": "RIDGEWOOD",
"state": "NY",
"postal_code": "113853330",
"telephone_number": "718-381-9500",
"fax_number": "718-381-9505"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "6415 FRESH POND RD",
"city": "RIDGEWOOD",
"state": "NY",
"postal_code": "113853330",
"telephone_number": "718-381-9500",
"fax_number": "718-381-9505"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LEDOVSKY",
"first_name": "TATYANA",
"middle_name": "M.",
"credential": "M.D.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2006-07-08",
"last_updated": "2011-04-18",
"status": "A"
},
"taxonomies": [
{
"code": "208000000X",
"taxonomy_group": "",
"desc": "Pediatrics",
"state": "NY",
"license": "214455",
"primary": true
},
{
"code": "2080P0204X",
"taxonomy_group": "",
"desc": "Pediatrics, Pediatric Emergency Medicine",
"state": "NY",
"license": "214455",
"primary": false
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "01980065",
"state": "NY"
}
],
"endpoints": [],
"other_names": []
}Other providers in Ridgewood, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 18, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.