Individual provider Active NPI

Boris Dubrovsky, PHD,CBSM,DBSM,RPSGT

  • Psychologist
  • Brooklyn, NY
National Provider Identifier
1194955526
Registry record updated Jul 29, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
License
018170 Issued in NY
Practice address
519 6TH St
Brooklyn, NY 11215-3608
Phone
(718) 780-3017
Fax
(718) 780-6711
NPI assigned
Jul 20, 2009
Last updated
Jul 29, 2024By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 29, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Psychologist 103T00000X 018170 NY Primary
Other Specialist/Technologist 246Z00000X 11039 NY

Addresses

Primary practice location

519 6TH St
Brooklyn, NY 11215-3608

Mailing address

509 6TH St
Brooklyn, NY 11215-3675
Phone (718) 780-3017

Electronic endpoints 3

TypeEndpointUseAffiliation
Direct Messaging Address bod9006@direct.nyp.ort Direct
FHIR URL https://epicproxy-pub.et1089.epichosted.com/FHIRProxy/api/FHIR/R4/ Health Information Exchange (HIE)
FHIR URL https://epicproxy-pub.et1089.epichosted.com/FHIRProxy/api/FHIR/DSTU2/ Health Information Exchange (HIE)

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY, FL, CT3 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 3

Enrollment IDStateProvider typePAC IDDetails
I20110516000163 NY Practitioner - Clinical Psychologist 9436335171 Reassigns benefits to 2 organizations
Practice locations: Bronx, NY
I20260416000343 FL Practitioner - Clinical Psychologist 9436335171 Reassigns benefits to 1 organization
I20260610000121 CT Practitioner - Clinical Psychologist 9436335171 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 2006
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Ny Metro Sleep Medical, P.C.Group PAC ID 2466637731, 3 clinicians
Kings Physician Services PCGroup PAC ID 0547579427, 643 clinicians
Drlullaby, LLCGroup PAC ID 9931507290, 7 clinicians

Practice addresses (Care Compare)

1250 Waters PL
Suite 505
Bronx, NY 10461-2732
Phone (718) 684-6393

506 6TH St
Brooklyn, NY 11215-3609
Phone (718) 780-3000

9701 NE 2ND Ave
Suite 1208
Miami Shores, FL 33138-2310
Phone (844) 475-3379

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
94.47 of 100Reported as group
Quality
84.67
Promoting interoperability
100
Improvement activities
40
Cost
71.47

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
11039NYMDOther Specialist/Technologist

Practice roles

OrganizationSpecialtyStatusNew patients
Kings Physician Services, PC CurrentSince May 30, 2017 Accepting new patients
Kings Physician Services, PC CurrentSince May 30, 2017 Accepting new patients

Locations

506 6th St
Brooklyn, NY 11215
Phone (718) 780-3279

506 6th St
Ste B
Brooklyn, NY 11215
Phone (718) 780-3677

Networks

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

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 5

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": "1248048000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1722211200000",
    "number": "1194955526",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "509 6TH ST",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112153675",
            "telephone_number": "718-780-3017",
            "fax_number": "718-780-6711"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "519 6TH ST",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112153608",
            "telephone_number": "718-780-3017",
            "fax_number": "718-780-6711"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DUBROVSKY",
        "first_name": "BORIS",
        "name_prefix": "Dr.",
        "credential": "PHD,CBSM,DBSM,RPSGT",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2009-07-20",
        "last_updated": "2024-07-29",
        "certification_date": "2024-07-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "NY",
            "license": "018170",
            "primary": true
        },
        {
            "code": "246Z00000X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Other",
            "state": "NY",
            "license": "11039",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "bod9006@direct.nyp.ort",
            "affiliation": "N",
            "endpointDescription": "Direct Address",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "Direct Address",
            "address_1": "519 6th St",
            "city": "Brooklyn",
            "state": "NY",
            "country_code": "US",
            "postal_code": "112153608",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://epicproxy-pub.et1089.epichosted.com/FHIRProxy/api/FHIR/R4/",
            "affiliation": "N",
            "endpointDescription": "FHIR",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "FHIR",
            "address_1": "519 6th St",
            "city": "Brooklyn",
            "state": "NY",
            "country_code": "US",
            "postal_code": "112153608",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://epicproxy-pub.et1089.epichosted.com/FHIRProxy/api/FHIR/DSTU2/",
            "affiliation": "N",
            "endpointDescription": "FHIR",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "FHIR",
            "address_1": "519 6th St",
            "city": "Brooklyn",
            "state": "NY",
            "country_code": "US",
            "postal_code": "112153608",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Brooklyn, NY

Sources for this page

Verify at the official NPI Registry.