Individual provider Active NPI

Yuly Gertsberg, DDS

  • Oral and Maxillofacial Surgery (Dentist)
  • Brooklyn, NY
National Provider Identifier
1255485165
Registry record updated Feb 12, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X
License
045056 Issued in NY
Practice address
1720 E 13TH St Ste 1
Brooklyn, NY 11229-1920
Phone
(718) 998-2929
Fax
(718) 998-1056
NPI assigned
Jan 22, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 12, 2019

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Oral and Maxillofacial Surgery (Dentist)Group: 193400000X SINGLE SPECIALTY GROUP 1223S0112X 045056 NY Primary
Dentist 122300000X 045056 NY

Addresses

Primary practice location

1720 E 13TH St Ste 1
Brooklyn, NY 11229-1920

Mailing address

1720 E 13TH St Ste 1
Brooklyn, NY 11229-1920
Phone (718) 998-2929

Other practice location 1

Metropolitan Hospital Faculty Practice
1901 First Ave. Rm 5 South 2
New York, NY 10029
Phone (212) 423-8462

Other identifiers 1

IdentifierTypeStateIssuer
01759237MedicaidNY

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
I20101222000800 NY Practitioner - Oral SurgeryPractitioner - Maxillofacial Surgery 8224226964 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Oral SurgeryAlso: Maxillofacial Surgery
Education
New York University College of Dentistry, 1993
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

1720 E 13TH St
Suite 1
Brooklyn, NY 11229-1920
Phone (718) 998-2929

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Metropolitan Medical Practice Plan PC Single Specialty CurrentSince Jul 1, 2011 Accepting new patients
Yuly Gertsberg Oral Surgery PC Oral and Maxillofacial Surgery CurrentSince Sep 19, 2010 Accepting new patients
Firstmed Pharmacy Inc. Current Accepting new patients
Nymhc FPP Nephrology Single Specialty Past Accepting new patients

Locations

1720 E 13th St
Ste 1
Brooklyn, NY 11229
Phone (718) 998-2929

1302 Kings Hwy
Fl 6
Brooklyn, NY 11229
Phone (718) 998-2929

1901 1st Ave
Rm 5
New York, NY 10029
Phone (212) 423-7095

1901 1st Ave
New York, NY 10029
Phone (212) 230-6262

Networks

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

Interoperability endpoints

  • Direct secure messaging: ygertsberg839650@nychhc.direct-ci.com

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1169424000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1549929600000",
    "number": "1255485165",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1720 E 13TH ST STE 1",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112291920",
            "telephone_number": "718-998-2929",
            "fax_number": "718-998-1056"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1720 E 13TH ST STE 1",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112291920",
            "telephone_number": "718-998-2929",
            "fax_number": "718-998-1056"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "Metropolitan Hospital Faculty Practice",
            "address_2": "1901 First Ave. Rm 5 South 2",
            "address_purpose": "LOCATION",
            "city": "New York",
            "state": "NY",
            "postal_code": "10029",
            "country_code": "US",
            "telephone_number": "212-423-8462",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GERTSBERG",
        "first_name": "YULY",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-01-22",
        "last_updated": "2019-02-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223S0112X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "NY",
            "license": "045056",
            "primary": true
        },
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "NY",
            "license": "045056",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01759237",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Brooklyn, NY

Sources for this page

Verify at the official NPI Registry.