Individual provider Active NPI

Inna Chernoglaz, P.A.

  • Medical Physician Assistant
  • Brooklyn, NY
National Provider Identifier
1225226756
Registry record updated Mar 16, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
011714 Issued in NY
Practice address
1632 E 16TH St
Brooklyn, NY 11229-1108
Phone
(718) 336-0330
Fax
(718) 336-0073
NPI assigned
Oct 10, 2007
Last updated
Mar 16, 2013By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 16, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X 011714 NY Primary

Addresses

Primary practice location

1632 E 16TH St
Brooklyn, NY 11229-1108

Mailing address

1632 E 16TH St
Brooklyn, NY 11229-1108
Phone (718) 336-0330

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20090213000483 NY Practitioner - Physician Assistant 9133284714 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2006
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Rimma Gelbert Medical PCGroup PAC ID 2365523743, 6 clinicians

Practice addresses (Care Compare)

1705 E 17TH St
Lowr Level
Brooklyn, NY 11229-2101
Phone (718) 336-0330

1705 E 17TH St
Lowr Level
Brooklyn, NY 11229-2645

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
011714NYMDMedical Physician Assistant

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1191974400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1363392000000",
    "number": "1225226756",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1632 E 16TH ST",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112291108",
            "telephone_number": "718-336-0330",
            "fax_number": "718-336-0073"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1632 E 16TH ST",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112291108",
            "telephone_number": "718-336-0330",
            "fax_number": "718-336-0073"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHERNOGLAZ",
        "first_name": "INNA",
        "credential": "P.A.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-10-10",
        "last_updated": "2013-03-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "NY",
            "license": "011714",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brooklyn, NY

Sources for this page

Verify at the official NPI Registry.