Individual provider Active NPI

Nelya Lobkova, D.P.M.

  • Podiatrist
  • New York, NY
National Provider Identifier
1255628889
Registry record updated Nov 15, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
PodiatristTaxonomy code 213E00000X
License
006527 Issued in NY
Practice address
291 Broadway # 810
New York, NY 10007-1814
Phone
(212) 606-4065
NPI assigned
Jul 4, 2011
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 15, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Podiatrist 213E00000X 25MD00322200 NJ
Podiatrist 213E00000X 006527 NY Primary

Addresses

Primary practice location

291 Broadway # 810
New York, NY 10007-1814

Mailing address

2639 E 26TH St
Brooklyn, NY 11235-2419
Phone (718) 753-9523

Other identifiers 1

IdentifierTypeStateIssuer
03794305MedicaidNY

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: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20140218001365 NY Practitioner - Podiatry 3476782392 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Podiatry
Education
New York College of Podiatric Medicine, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Step Up Surgical Podiatry, PLLCGroup PAC ID 3971827445, 2 clinicians

Practice addresses (Care Compare)

291 Broadway
RM 810
New York, NY 10007-1912
Phone (212) 606-4065

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of tissue1-10
Removal of skin lesions1-10
Removal of nail tissue61

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
25MD00322200NJMDPodiatrist

Practice roles

OrganizationSpecialtyStatusNew patients
Park Place Podiatry PLLC CurrentSince Jun 11, 2017 Accepting new patients
Step Up Surgical Podiatry, PLLC Podiatrist CurrentSince Sep 9, 2014 Accepting new patients

Locations

291 Broadway
Rm 810
New York, NY 10007
Phone (212) 484-0922

Organizations & group practices 2

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": "1309737600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1605398400000",
    "number": "1255628889",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2639 E 26TH ST",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112352419",
            "telephone_number": "718-753-9523"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "291 BROADWAY # 810",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100071814",
            "telephone_number": "212-606-4065"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LOBKOVA",
        "first_name": "NELYA",
        "credential": "D.P.M.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2011-07-04",
        "last_updated": "2020-11-15",
        "certification_date": "2020-11-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "213E00000X",
            "taxonomy_group": "",
            "desc": "Podiatrist",
            "state": "NJ",
            "license": "25MD00322200",
            "primary": false
        },
        {
            "code": "213E00000X",
            "taxonomy_group": "",
            "desc": "Podiatrist",
            "state": "NY",
            "license": "006527",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "03794305",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

Verify at the official NPI Registry.