Individual provider Active NPI

Dvir Koenigstein, MD

  • Retina Specialist (Ophthalmology) Physician
  • Bronx, NY
National Provider Identifier
1194316869
Registry record updated Dec 12, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Retina Specialist (Ophthalmology) PhysicianTaxonomy code 207WX0107X
License
315194 Issued in NY
Practice address
1650 Grand Concourse
Eye Clinic, Ground Floor
Bronx, NY 10457-7606
Phone
(718) 960-2020
Fax
(718) 960-2045
NPI assigned
Jan 26, 2021
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 12, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Ophthalmology Physician 207W00000X 315194 NY
Retina Specialist (Ophthalmology) Physician 207WX0107X 315194 NY Primary

Addresses

Primary practice location

1650 Grand Concourse
Eye Clinic, Ground Floor
Bronx, NY 10457-7606

Mailing address

401 E 80TH St Apt 7G
New York, NY 10075-0685
Phone (347) 577-3760

Other practice location 1

630 W 168th St
New York, NY 10032-3725
Phone (646) 876-6734

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
I20220718002172 NY Practitioner - Ophthalmology 7113308487 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Ophthalmology
Education
Other, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Bronxcare Health SystemGroup PAC ID 3870404429, 335 clinicians
SBH Physicians PCGroup PAC ID 3072798941, 178 clinicians

Practice addresses (Care Compare)

1276 Fulton Ave
Bronx, NY 10456-3402

1650 Grand Concourse
Bronx, NY 10457-7606

4487 3Rd Ave
Bronx, NY 10457-1526
Phone (718) 960-6392

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Cataract surgery1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
315194NYMDRetina Specialist (Ophthalmology) Physician

Practice roles

OrganizationSpecialtyStatusNew patients
SBH Physicians, PC CurrentSince Jun 22, 2022 Accepting new patients
Bronxcare Health System Current Accepting new patients
Bronxcare Health System CurrentSince Jun 24, 2022 Accepting new patients
Bronxcare Health System Ophthalmology CurrentSince Jun 24, 2022 Accepting new patients
SBH Physicians, PC CurrentSince Jun 22, 2022 Accepting new patients

Locations

111 E 210th St
Bronx, NY 10467

4487 3rd Ave
Bronx, NY 10457
Phone (718) 960-3730

1276 Fulton Ave
Bronx, NY 10456
Phone (718) 518-5000

1650 Grand Concourse
Bronx, NY 10457
Phone (718) 294-7104

Networks

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

Interoperability endpoints

  • Direct secure messaging: dkoenigstein18908@sbhny.direct-ci.net

Organizations & group practices 5

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.

Hospital & facility affiliations 2

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

NPI Registry JSON

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

{
    "created_epoch": "1611619200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1670803200000",
    "number": "1194316869",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "401 E 80TH ST APT 7G",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100750685",
            "telephone_number": "347-577-3760"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1650 GRAND CONCOURSE",
            "address_2": "EYE CLINIC, GROUND FLOOR",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "104577606",
            "telephone_number": "718-960-2020",
            "fax_number": "718-960-2045"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "630 W 168th St",
            "address_purpose": "LOCATION",
            "city": "New York",
            "state": "NY",
            "postal_code": "100323725",
            "country_code": "US",
            "telephone_number": "646-876-6734",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KOENIGSTEIN",
        "first_name": "DVIR",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2021-01-26",
        "last_updated": "2022-12-12",
        "certification_date": "2022-12-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "NY",
            "license": "315194",
            "primary": false
        },
        {
            "code": "207WX0107X",
            "taxonomy_group": "",
            "desc": "Ophthalmology, Retina Specialist",
            "state": "NY",
            "license": "315194",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bronx, NY

Sources for this page

Verify at the official NPI Registry.