Individual provider Active NPI

Yevgeniy A Korshunov, MD

  • Orthopaedic Surgery Physician
  • Staten Island, NY
National Provider Identifier
1194961078
Registry record updated May 13, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthopaedic Surgery PhysicianTaxonomy code 207X00000X
License
269467 Issued in NY
Practice address
1551 Richmond Rd Ste 1a
Staten Island, NY 10304-2338
Phone
(718) 727-6945
Fax
(718) 727-6958
NPI assigned
Dec 26, 2008
Last updated
May 13, 2024By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 13, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Reconstructive Orthopaedic Surgery Physician 207XS0114X 269467 NY
Orthopaedic Surgery Physician 207X00000X 269467 NY Primary

Addresses

Primary practice location

1551 Richmond Rd Ste 1a
Staten Island, NY 10304-2338

Mailing address

1551 Richmond Rd Ste 1a
Staten Island, NY 10304-2338
Phone (718) 727-6945

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
I20141020001184 NY Practitioner - Orthopedic Surgery 1456572221 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Orthopedic Surgery
Education
State University of New York Downstate Medical Center, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
True North Medical Group PCGroup PAC ID 7012194806, 185 clinicians

Practice addresses (Care Compare)

100 E 77TH St
New York, NY 10075-1850
Phone (212) 289-0171

1551 Richmond Rd
Suite 1a
Staten Island, NY 10304-2338
Phone (718) 727-6958

36 Lincoln Ave
Rockville Centre, NY 11570-5768
Phone (516) 536-2800

375 Seguine Ave
Staten Island, NY 10309-3932
Phone (718) 226-1939

475 Seaview Ave
Staten Island, NY 10305-3436
Phone (718) 226-9292

501 Seaview Ave
Staten Island, NY 10305-3419
Phone (718) 984-2642

515 W 36TH St
FL 7
New York, NY 10018-1245
Phone (212) 734-0407

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
81.27 of 100Reported as group
Quality
66.64
Promoting interoperability
100
Improvement activities
40
Cost
70.94

Merit-based Incentive Payment System (MIPS)

Final score
93.07 of 100Reported as apm
Quality
79.77
Promoting interoperability
88.77
Improvement activities
40

Procedures performed for Medicare patients

ProcedureNumber of procedures
Hip replacement36
Knee replacement22
Removal of tissue1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
269467NYMDAdult Reconstructive Orthopaedic Surgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
North Shore-Lij Medical PC Orthopaedic Surgery CurrentSince Feb 4, 2018 Accepting new patients
True North Medical Group PC Orthopaedic Surgery CurrentSince Apr 8, 2024 Accepting new patients
True North Medical Group PC Orthopaedic Surgery CurrentSince Apr 8, 2024 Accepting new patients
Staten Island University Hospital Past Accepting new patients
True North Medical Group PC Past Accepting new patients

Locations

2510 30th Ave
Long Island City, NY 11102
Phone (718) 267-4245

300 Community Dr
Manhasset, NY 11030

1111 Marcus Ave
Ste M04
New Hyde Park, NY 11042
Phone (585) 736-3650

130 E 77th St
New York, NY 10075
Phone (212) 434-2606

130 E 77th St
Fl 5
New York, NY 10075

525 W 36th St
Fl 7
New York, NY 10018
Phone (646) 429-0016

36 Lincoln Ave
Fl 3
Rockville Ctr, NY 11570

1551 Richmond Rd
Ste 1A
Staten Island, NY 10304
Phone (718) 303-0140

375 Seguine Ave
Staten Island, NY 10309
Phone (718) 226-2000

Networks

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

Interoperability endpoints

  • Direct secure messaging: ykorshunov70424@northwell.direct-ci.com

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

Hospital & facility affiliations 4

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": "1230249600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1715558400000",
    "number": "1194961078",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1551 RICHMOND RD STE 1A",
            "city": "STATEN ISLAND",
            "state": "NY",
            "postal_code": "103042338",
            "telephone_number": "718-727-6945",
            "fax_number": "718-727-6958"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1551 RICHMOND RD STE 1A",
            "city": "STATEN ISLAND",
            "state": "NY",
            "postal_code": "103042338",
            "telephone_number": "718-727-6945",
            "fax_number": "718-727-6958"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KORSHUNOV",
        "first_name": "YEVGENIY",
        "middle_name": "A",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-12-26",
        "last_updated": "2024-05-13",
        "certification_date": "2024-05-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207XS0114X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery, Adult Reconstructive Orthopaedic Surgery",
            "state": "NY",
            "license": "269467",
            "primary": false
        },
        {
            "code": "207X00000X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery",
            "state": "NY",
            "license": "269467",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Staten Island, NY

Sources for this page

Verify at the official NPI Registry.