Individual provider Active NPI

Elena Kruglyak, MD

  • Medical Oncology Physician
  • Delray Beach, FL
National Provider Identifier
1265420020
Registry record updated Jul 31, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Oncology PhysicianTaxonomy code 207RX0202X
License
ME68735 Issued in FL
Practice address
5130 Linton Blvd Ste B4
Delray Beach, FL 33484-6595
Phone
(561) 808-0098
Fax
(561) 496-0592
NPI assigned
Oct 6, 2005
Last updated
Jul 31, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 31, 2024

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X ME68735 FL
Hematology (Internal Medicine) Physician 207RH0000X ME68735 FL
Medical Oncology Physician 207RX0202X ME68735 FL Primary

Addresses

Primary practice location

5130 Linton Blvd Ste B4
Delray Beach, FL 33484-6595

Mailing address

PO Box 102222
Atlanta, GA 30368-2222
Phone (239) 274-8200

Other practice location 1

9970 Central Park Blvd N
Suite 304
Boca Raton, FL 33428-2231
Phone (561) 482-6611

Other identifiers 12

IdentifierTypeStateIssuer
QMP000003849305OtherFLMOLINA
252889OtherFLAVMED
DELRAY456OtherFLRR MEDICARE
27290OtherFLBCBS
264956000MedicaidFL
6664OtherFLDIMENSION HEALTH
P1001984OtherFLFREEDOM
5475027OtherFLAETNA
P954880OtherFLOPTIMUM
102794200MedicaidFL
1255024OtherFLWELLCARE
6550599OtherFLCIGNA

Other names 1

  • Elena Kruglyak Other name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
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
I20100512000494 FL Practitioner - Medical OncologyPractitioner - Internal MedicinePractitioner - Hospice/Palliative CarePractitioner - Hematology/Oncology 3779611736 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Medical Oncology
Education
Other, 1988
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

5130 Linton Blvd
Suite B4
Delray Beach, FL 33484-6595
Phone (561) 808-0098

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
ME68735FLMDMedical Oncology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Florida Cancer Specialists & Research Institute, LLC Hematology CurrentSince Dec 13, 2022 Accepting new patients
Vitas Solutions Inc CurrentSince Sep 1, 2020 Accepting new patients
Florida Cancer Specialists & Research Institute, LLC Medical Oncology PastSince Jun 18, 2023 Accepting new patients
Genesiscare USA of Florida LLC Past Accepting new patients
Comprehensive Cancer Centers Inc Specialist Past Accepting new patients
Comprehensive Cancer Centers Inc Specialist Past Accepting new patients

Locations

21020 State Road 7
Boca Raton, FL 33428
Phone (561) 883-7502

21020 State Road 7
Ste 200C
Boca Raton, FL 33428
Phone (561) 409-1071

5130 Linton Blvd
Ste B4
Delray Beach, FL 33484
Phone (561) 808-0098

3840 Broadway
Fort Myers, FL 33901
Phone (239) 275-6400

5430 NW 33rd Ave
Ste 106
Ft Lauderdale, FL 33309
Phone (877) 884-8277

100 Century Blvd
Ste 101
West Palm Beach, FL 33417

Networks

  • Optimum HealthCare HMO Network
  • Freedom Health HMO Network

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 3

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": "1128556800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1722384000000",
    "number": "1265420020",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 102222",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303682222",
            "telephone_number": "239-274-8200"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5130 LINTON BLVD STE B4",
            "city": "DELRAY BEACH",
            "state": "FL",
            "postal_code": "334846595",
            "telephone_number": "561-808-0098",
            "fax_number": "561-496-0592"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "9970 Central Park Blvd N",
            "address_2": "Suite 304",
            "address_purpose": "LOCATION",
            "city": "Boca Raton",
            "state": "FL",
            "postal_code": "334282231",
            "country_code": "US",
            "telephone_number": "561-482-6611",
            "fax_number": "561-482-3056",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KRUGLYAK",
        "first_name": "ELENA",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-10-06",
        "last_updated": "2024-07-31",
        "certification_date": "2024-07-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "FL",
            "license": "ME68735",
            "primary": false
        },
        {
            "code": "207RH0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Hematology",
            "state": "FL",
            "license": "ME68735",
            "primary": false
        },
        {
            "code": "207RX0202X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Medical Oncology",
            "state": "FL",
            "license": "ME68735",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MOLINA",
            "identifier": "QMP000003849305",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AVMED",
            "identifier": "252889",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE",
            "identifier": "DELRAY456",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "27290",
            "state": "FL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "264956000",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DIMENSION HEALTH",
            "identifier": "6664",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "FREEDOM",
            "identifier": "P1001984",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "5475027",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OPTIMUM",
            "identifier": "P954880",
            "state": "FL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "102794200",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "WELLCARE",
            "identifier": "1255024",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CIGNA",
            "identifier": "6550599",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ELENA",
            "last_name": "KRUGLYAK",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Delray Beach, FL

Sources for this page

Verify at the official NPI Registry.