Individual provider Active NPI

Olga Tyuleneva, M.D.

  • Interventional Pain Medicine Physician
  • Brooklyn, NY
National Provider Identifier
1235123597
Registry record updated Jul 18, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Interventional Pain Medicine PhysicianTaxonomy code 208VP0014X
License
226635 Issued in NY
Practice address
1120 Brighton Beach Ave
Unit 1XZ
Brooklyn, NY 11235-5572
Phone
(718) 232-5050
Fax
(718) 232-1269
NPI assigned
Sep 1, 2005
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 18, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Interventional Pain Medicine Physician 208VP0014X 226635 NY Primary

Addresses

Primary practice location

1120 Brighton Beach Ave
Unit 1XZ
Brooklyn, NY 11235-5572

Mailing address

1120 Brighton Beach Ave
Unit 1XZ
Brooklyn, NY 11235-5572
Phone (718) 232-5050

Other identifiers 1

IdentifierTypeStateIssuer
02367251MedicaidNY

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
I20040507000043 NY Practitioner - AnesthesiologyPractitioner - Interventional Pain Management 0042209983 Reassigns benefits to 2 organizations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Org Medical PLLC CurrentSince Apr 1, 2008 Accepting new patients
Ora Medical PLLC CurrentSince Apr 11, 2004 Accepting new patients
University Physicians of Brooklyn, Inc Past Accepting new patients
Real Medical Health PLLC Past Accepting new patients
Bukhman MD PC PastSince Apr 1, 2008 Accepting new patients
Brooklyn Anesthesia Medical Group, PLLC Past Accepting new patients

Organizations & group practices 6

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": "1125532800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1310947200000",
    "number": "1235123597",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1120 BRIGHTON BEACH AVE",
            "address_2": "UNIT 1XZ",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112355572",
            "telephone_number": "718-232-5050",
            "fax_number": "718-232-1269"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1120 BRIGHTON BEACH AVE",
            "address_2": "UNIT 1XZ",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112355572",
            "telephone_number": "718-232-5050",
            "fax_number": "718-232-1269"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TYULENEVA",
        "first_name": "OLGA",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-09-01",
        "last_updated": "2011-07-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208VP0014X",
            "taxonomy_group": "",
            "desc": "Pain Medicine, Interventional Pain Medicine",
            "state": "NY",
            "license": "226635",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02367251",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Brooklyn, NY

Sources for this page

Verify at the official NPI Registry.