NPIMap

Individual provider Active NPI

Boris Itskovich, M.D

  • Internal Medicine Physician
  • Brooklyn, NY
National Provider Identifier
1235197252
Registry record updated Feb 18, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
207492 Issued in NY
Practice address
2993 Ocean Pkwy
Brooklyn, NY 11235-8302
Phone
(718) 373-0777
Fax
(718) 373-8454
NPI assigned
May 1, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 18, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 207492 NY Primary

Addresses

Primary practice location

2993 Ocean Pkwy
Brooklyn, NY 11235-8302

Mailing address

2693 Arkansas Dr
Brooklyn, NY 11234-6833
Phone (718) 373-0777

Other identifiers 4

IdentifierTypeStateIssuer
P825169OtherNYOXFORD
01799137MedicaidNY
2599419OtherNYGHI
BKX072001OtherNYAMERICHOICE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050126000390 NY Practitioner - Internal Medicine 6103876347 Practice locations: Brooklyn, NY

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 1976
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

2993 Ocean Pkwy
Brooklyn, NY 11235-8302
Phone (718) 373-0777

3009 Ocean Pkwy
Brooklyn, NY 11235-8302

Hospital & facility affiliations

  • Girling Health Care of New York Home health agency, Brooklyn, NY, CCN 337243
  • Prime Home Health Services, LLC Home health agency, Brooklyn, NY, CCN 337190
  • South Brooklyn Health Hospital, Brooklyn, NY, CCN 330196
  • Maimonides Medical Center Hospital, Brooklyn, NY, CCN 330194

Procedures performed for Medicare patients

ProcedureNumber of procedures
Skin biopsy1-10

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Maimonides Medical Center Current Accepting new patients
On-Site Psychological Services PC Past Accepting new patients
Interphase Medical Care P.C. Past Accepting new patients
Boris Itskovich, MD PastSince Jan 1, 2013 Accepting new patients
Adaptation Medical, PC Internal Medicine Past Accepting new patients
New York City Health and Hospitals Corporation Internal Medicine Past Accepting new patients

Networks

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

Interoperability endpoints

  • Direct secure messaging: borisitskovich@mai.allscriptsdirect.net

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.

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": "1146441600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1455753600000",
    "number": "1235197252",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2693 ARKANSAS DR",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112346833",
            "telephone_number": "718-373-0777",
            "fax_number": "718-373-8454"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2993 OCEAN PKWY",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112358302",
            "telephone_number": "718-373-0777",
            "fax_number": "718-373-8454"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ITSKOVICH",
        "first_name": "BORIS",
        "credential": "M.D",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-05-01",
        "last_updated": "2016-02-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NY",
            "license": "207492",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OXFORD",
            "identifier": "P825169",
            "state": "NY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01799137",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GHI",
            "identifier": "2599419",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AMERICHOICE",
            "identifier": "BKX072001",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Brooklyn, NY

Sources for this page

Verify at the official NPI Registry.