Individual provider Active NPI

Tatyana P Tsipursky, MD

  • Psychiatry Physician
  • Brooklyn, NY
National Provider Identifier
1275506974
Registry record updated Mar 5, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
211846 Issued in NY
Practice address
2580 Ocean Pkwy
Suite L1D
Brooklyn, NY 11235-7746
Phone
(718) 336-1366
Fax
(718) 336-1766
NPI assigned
Feb 12, 2006
Last updated
Mar 5, 2014By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 5, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician 2084P0800X 211846 NY Primary

Addresses

Primary practice location

2580 Ocean Pkwy
Suite L1D
Brooklyn, NY 11235-7746

Mailing address

753 Park LN
North Woodmere, NY 11581-3640
Phone (718) 616-5437

Other identifiers 1

IdentifierTypeStateIssuer
01971764MedicaidNY

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
I20040112000521 NY Practitioner - Psychiatry 9638079957 Reassigns benefits to 1 organization
Practice locations: Brooklyn, NY

Care Compare profile

Medicare Care Compare
Specialty
Psychiatry
Education
Other, 1972
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

2580 Ocean Pkwy
Brooklyn, NY 11235-7707
Phone (718) 336-1366

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
211846NYMDPsychiatry Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Coney Island Medical Practice Plan, P.C. CurrentSince Jul 13, 2011 Accepting new patients
University Group Medical Associates, P.C Psychiatry Past Accepting new patients

Locations

2601 Ocean Pkwy
Brooklyn, NY 11235
Phone (718) 616-5354

Networks

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

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

NPI Registry JSON

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

{
    "created_epoch": "1139702400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1393977600000",
    "number": "1275506974",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "753 PARK LN",
            "city": "NORTH WOODMERE",
            "state": "NY",
            "postal_code": "115813640",
            "telephone_number": "718-616-5437",
            "fax_number": "718-336-1766"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2580 OCEAN PKWY",
            "address_2": "SUITE L1D",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112357746",
            "telephone_number": "718-336-1366",
            "fax_number": "718-336-1766"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TSIPURSKY",
        "first_name": "TATYANA",
        "middle_name": "P",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-02-12",
        "last_updated": "2014-03-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "NY",
            "license": "211846",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01971764",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Brooklyn, NY

Sources for this page

Verify at the official NPI Registry.