Individual provider Active NPI

Oleg Lushpenko, MD, DO

  • Family Medicine Physician
  • Brooklyn, NY
National Provider Identifier
1184662181
Registry record updated Jul 13, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
227264 Issued in NY
Practice address
580 Pennsylvania Ave
Brooklyn, NY 11207-6308
Phone
(718) 498-4420
NPI assigned
Jun 2, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 13, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 227264 NY Primary

Addresses

Primary practice location

580 Pennsylvania Ave
Brooklyn, NY 11207-6308

Mailing address

580 Pennsylvania Ave
Brooklyn, NY 11207-6308
Phone (718) 498-4420

Other identifiers 1

IdentifierTypeStateIssuer
02388829MedicaidNJ

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
I20040628000304 NY Practitioner - Family PracticePractitioner - Osteopathic Manipulative Medicine 5597741025 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family PracticeAlso: Osteopathic Manipulative Medicine
Education
New York College of Osteo Medicine of New York Institute of Technology, 2000
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

580 Pennsylvania Ave
Brooklyn, NY 11207-6308
Phone (718) 498-4420

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
227264NYMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Next Door Medical, PC Family Medicine CurrentSince Jul 25, 2003 Accepting new patients
Jal 28 LLC Past Accepting new patients
Mermaid Management Inc Family Medicine PastSince Dec 15, 2020 Accepting new patients

Locations

580 Pennsylvania Ave
Brooklyn, NY 11207
Phone (718) 498-4420

580 Pennsylvania Ave
#P
Brooklyn, NY 11207
Phone (718) 498-4920

Networks

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

Organizations & group practices 3

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": "1149206400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783900800000",
    "number": "1184662181",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "580 PENNSYLVANIA AVE",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112076308",
            "telephone_number": "718-498-4420"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "580 PENNSYLVANIA AVE",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112076308",
            "telephone_number": "718-498-4420"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LUSHPENKO",
        "first_name": "OLEG",
        "credential": "MD, DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-02",
        "last_updated": "2026-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NY",
            "license": "227264",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02388829",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Brooklyn, NY

Sources for this page

Verify at the official NPI Registry.